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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
The Benefits or Otherwise of Managing Malaria Cases with or without Laboratory Diagnosis: The Experience in a District Hospital in Ghana
PLoS ONE, Volume 8, No. 3, Article e58107, Year 2013
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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. © 2013 Osei-Kwakye et al.
Authors & Co-Authors
Osei-Kwakye, Kingsley
Unknown Affiliation
Asante, Kwaku Poku
Unknown Affiliation
Mahama, Emmanuel N.
Unknown Affiliation
Apanga, Stephen
Unknown Affiliation
Owusu, Ruth
Unknown Affiliation
Kwara, Evans
Unknown Affiliation
Adjei, George
Unknown Affiliation
Abokyi, Livesy Naafoe
Unknown Affiliation
Enuameh, Yeetey Akpe Kwesi
Unknown Affiliation
Dosoo, David Kwame
Unknown Affiliation
Punguyire, Damien Tioyire
Unknown Affiliation
Owusu-Agyei, Seth
Unknown Affiliation
Statistics
Citations: 26
Authors: 12
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pone.0058107
e-ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Locations
Ghana