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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Symptomatic malaria diagnosis overestimate malaria prevalence, but underestimate anaemia burdens in children: Results of a follow up study in Kenya
BMC Public Health, Volume 14, No. 1, Article 332, Year 2014
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Description
Background: The commonly accepted gold standard diagnostic method for detecting malaria is a microscopic reading of Giemsa-stained blood films. However, symptomatic diagnosis remains the basis of therapeutic care for the majority of febrile patients in malaria endemic areas. This study aims to compare the discrepancy in malaria and anaemia burdens between symptomatic diagnosed patients with those diagnosed through the laboratory. Methods. Data were collected from Western Kenya during a follow-up study of 887 children with suspected cases of malaria visiting the health facilities. In the laboratory, blood samples were analysed for malaria parasite and haemoglobin levels. Differences in malaria prevalence between symptomatic diagnosis and laboratory diagnosis were analysed by Chi-square test. Bayesian probabilities were used for the approximation of the malaria and anaemia burdens. Regression analysis was applied to: (1) determine the relationships between haemoglobin levels, and malaria parasite density and (2) relate the prevalence of anaemia and the prevalence of malaria. Results: The prevalence of malaria and anaemia ranged from 10% to 34%, being highest during the rainy seasons. The predominant malaria parasite was P. falciparum (92.3%), which occurred in higher density in children aged 25 years. Fever, high temperature, sweating, shivering, vomiting and severe headache symptoms were associated with malaria during presumptive diagnosis. After conducting laboratory diagnosis, lower malaria prevalence was reported among the presumptively diagnosed patients. Surprisingly, there were no attempts to detect anaemia in the same cohort. There was a significant negative correlation between Hb levels and parasite density. We also found a positive correlation between the prevalence of anaemia and the prevalence of malaria after laboratory diagnosis indicating possible co-occurrence of malaria and anaemia. Conclusion: Symptomatic diagnosis of malaria overestimates malaria prevalence, but underestimates the anaemia burden in children. Good clinical practice dictates that a laboratory should confirm the presence of parasites for all suspected cases of malaria. © 2014 Choge et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Choge, Joseph K.
Kenya
Kabianga University College
Magak, Ng'wena Gideon
Kenya, Eldoret
Moi University
Akhwale, Willis S.
United States, Atlanta
Centers for Disease Control and Prevention
Koech, Julius K.
Kenya, Eldoret
Moi University
Ngeiywa, Moses M.
Kenya, Karatina
Karatina University
Oyoo-Okoth, Elijah
Kenya, Karatina
Karatina University
Netherlands, Amsterdam
Institute for Biodiversity and Ecosystem Dynamics - Amsterdam
Esamai, Fabian O.
Kenya, Eldoret
Moi University
Osano, Odipo
Kenya, Eldoret
University of Eldoret
Khayeka-Wandabwa, Christopher
Kenya, Nairobi
Jomo Kenyatta University of Agriculture and Technology
Kweka, Eliningaya J.
Tanzania, Arusha
Tropical Pesticides Research Institute
Statistics
Citations: 23
Authors: 10
Affiliations: 8
Identifiers
Doi:
10.1186/1471-2458-14-332
e-ISSN:
14712458
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
Kenya