The benefits or otherwise of managing malaria cases with or without laboratory diagnosis: the experience in a district hospital in Ghana.
BACKGROUND: This study was conducted at the Kintampo Municipal Hospital in Ghana to determine whether there was any benefit (or otherwise) in basing the management of cases of suspected malaria solely on laboratory confirmation (microscopy or by RDT) as compared with presumptive diagnosis. METHOD: C...
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doaj-dcfb3e2b26ec4bea864f9fccb222ffb82020-11-24T21:52:47ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0183e5810710.1371/journal.pone.0058107The benefits or otherwise of managing malaria cases with or without laboratory diagnosis: the experience in a district hospital in Ghana.Kingsley Osei-KwakyeKwaku Poku AsanteEmmanuel MahamaStephen ApangaRuth OwusuEvans KwaraGeorge AdjeiLivesy AbokyiEnuameh YeeteyDavid Kwame DosooDamien PunguyireSeth Owusu-AgyeiBACKGROUND: This study was conducted at the Kintampo Municipal Hospital in Ghana to determine whether there was any benefit (or otherwise) in basing the management of cases of suspected malaria solely on laboratory confirmation (microscopy or by RDT) as compared with presumptive diagnosis. METHOD: Children under five years who reported at the Out-Patient Department of the Hospital with axillary temperature ≥37.5°C or with a 48 hr history of fever were enrolled and had malaria microscopy and RDT performed. The attending clinician was blinded from laboratory results unless a request for these tests had been made earlier. Diagnosis of malaria was based on three main methods: presumptive or microscopy and/or RDT. Cost implication for adopting laboratory diagnosis or not was determined to inform malaria control programmes. RESULTS: In total, 936 children were enrolled in the study. Proportions of malaria diagnosed presumptively, by RDT and microscopy were 73.6% (689/936), 66.0% (618/936) and 43.2% (404/936) respectively. Over 50% (170/318) of the children who were RDT negative and 60% (321/532) who were microscopy negative were treated for malaria when presumptive diagnoses were used. Comparing the methods of diagnoses, the cost of malaria treatment could have been reduced by 24% and 46% in the RDT and microscopy groups respectively; the reduction was greater in the dry season (43% vs. 50%) compared with the wet season (20% vs. 45%) for the RDT and microscopy confirmed cases respectively. DISCUSSION/CONCLUSION: Over-diagnosis of malaria was prevalent in Kintampo during the period of the study. Though the use of RDT for diagnosis of malaria might have improved the quality of care for children, it appeared not to have a cost saving effect on the management of children with suspected malaria. Further research may be needed to confirm this.http://europepmc.org/articles/PMC3591456?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kingsley Osei-Kwakye Kwaku Poku Asante Emmanuel Mahama Stephen Apanga Ruth Owusu Evans Kwara George Adjei Livesy Abokyi Enuameh Yeetey David Kwame Dosoo Damien Punguyire Seth Owusu-Agyei |
spellingShingle |
Kingsley Osei-Kwakye Kwaku Poku Asante Emmanuel Mahama Stephen Apanga Ruth Owusu Evans Kwara George Adjei Livesy Abokyi Enuameh Yeetey David Kwame Dosoo Damien Punguyire Seth Owusu-Agyei The benefits or otherwise of managing malaria cases with or without laboratory diagnosis: the experience in a district hospital in Ghana. PLoS ONE |
author_facet |
Kingsley Osei-Kwakye Kwaku Poku Asante Emmanuel Mahama Stephen Apanga Ruth Owusu Evans Kwara George Adjei Livesy Abokyi Enuameh Yeetey David Kwame Dosoo Damien Punguyire Seth Owusu-Agyei |
author_sort |
Kingsley Osei-Kwakye |
title |
The benefits or otherwise of managing malaria cases with or without laboratory diagnosis: the experience in a district hospital in Ghana. |
title_short |
The benefits or otherwise of managing malaria cases with or without laboratory diagnosis: the experience in a district hospital in Ghana. |
title_full |
The benefits or otherwise of managing malaria cases with or without laboratory diagnosis: the experience in a district hospital in Ghana. |
title_fullStr |
The benefits or otherwise of managing malaria cases with or without laboratory diagnosis: the experience in a district hospital in Ghana. |
title_full_unstemmed |
The benefits or otherwise of managing malaria cases with or without laboratory diagnosis: the experience in a district hospital in Ghana. |
title_sort |
benefits or otherwise of managing malaria cases with or without laboratory diagnosis: the experience in a district hospital in ghana. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2013-01-01 |
description |
BACKGROUND: This study was conducted at the Kintampo Municipal Hospital in Ghana to determine whether there was any benefit (or otherwise) in basing the management of cases of suspected malaria solely on laboratory confirmation (microscopy or by RDT) as compared with presumptive diagnosis. METHOD: Children under five years who reported at the Out-Patient Department of the Hospital with axillary temperature ≥37.5°C or with a 48 hr history of fever were enrolled and had malaria microscopy and RDT performed. The attending clinician was blinded from laboratory results unless a request for these tests had been made earlier. Diagnosis of malaria was based on three main methods: presumptive or microscopy and/or RDT. Cost implication for adopting laboratory diagnosis or not was determined to inform malaria control programmes. RESULTS: In total, 936 children were enrolled in the study. Proportions of malaria diagnosed presumptively, by RDT and microscopy were 73.6% (689/936), 66.0% (618/936) and 43.2% (404/936) respectively. Over 50% (170/318) of the children who were RDT negative and 60% (321/532) who were microscopy negative were treated for malaria when presumptive diagnoses were used. Comparing the methods of diagnoses, the cost of malaria treatment could have been reduced by 24% and 46% in the RDT and microscopy groups respectively; the reduction was greater in the dry season (43% vs. 50%) compared with the wet season (20% vs. 45%) for the RDT and microscopy confirmed cases respectively. DISCUSSION/CONCLUSION: Over-diagnosis of malaria was prevalent in Kintampo during the period of the study. Though the use of RDT for diagnosis of malaria might have improved the quality of care for children, it appeared not to have a cost saving effect on the management of children with suspected malaria. Further research may be needed to confirm this. |
url |
http://europepmc.org/articles/PMC3591456?pdf=render |
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