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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
agricultural and biological sciences
Malaria among adult inpatients in two Tanzanian referral hospitals: A prospective study
Acta Tropica, Volume 134, No. 1, Year 2014
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Description
Most malaria research in sub-Saharan Africa has focused on children and pregnant women, but malaria among hospitalized adults in this region is poorly characterized. In this prospective study, we assessed the prevalence and clinical characteristics of malaria among the inpatient adults in two hospitals in Tanzania. We enrolled adults admitted with suspected malaria and performed routine thick blood smear (BS) and malaria rapid diagnostic tests (RDT). We also assessed malaria parasite clearance rates. We considered malaria status 'confirmed' or 'excluded' only in patients with two concordant tests. Malaria polymerase chain reaction (PCR) was performed in a subset of patients with discordant BS and RDT. After BS and RDT were performed on 579 adults with suspected malaria, malaria was excluded in 458/579 (79.1%) and confirmed in 16/579 (2.8%). One hundred and five out of 579 (18.1%) had discordant results. The prevalences of positive BS and positive RDT were 102/579 (17.6%) and 35/579 (6.0%), respectively, with only fair agreement (Kappa. =. 0.354, p<. 0.0001). PCR results agreed with RDT in 35/35 (100%) of patients with a negative RDT but positive BS. PCR results also agreed with RDT in 9/13 (69.2%) of cases with a positive RDT but negative BS. Clinical correlates of malaria by multivariable analysis included subjective fever (OR 3.6 [1.0-12.3], p=. 0.04), headache (OR 3.1 [1.2-8.0], p=. 0.02) and vomiting (OR 2.7 [1.2-6.4], p=. 0.02). Malaria parasite clearance was significantly delayed in the HIV-infected group. Our study demonstrated only fair agreement between RDT and BS malaria tests among Tanzanian adult inpatients with suspected malaria. PCR generally agreed with RDT results. HIV was associated with delayed parasite clearance in adults with malaria. We recommend the routine use of RDTs for malaria diagnosis among adults admitted to hospitals in sub-Saharan Africa. © 2014 Elsevier B.V.
Authors & Co-Authors
Kilonzo, Semvua Bukheti
Tanzania, Mwanza
Catholic University of Health and Allied Sciences
Tanzania, Mwanza
Bugando Medical Centre
Kamugisha, Erasmus
Tanzania, Mwanza
Catholic University of Health and Allied Sciences
Downs, Jennifer Alzos
Tanzania, Mwanza
Catholic University of Health and Allied Sciences
Tanzania, Mwanza
Bugando Medical Centre
United States, New York
Weill Cornell Medicine
Kataraihya, Johannes B.
Tanzania, Mwanza
Catholic University of Health and Allied Sciences
Tanzania, Mwanza
Bugando Medical Centre
Onesmo, Rwakyendela
Tanzania, Mwanza
Sekou Toure Regional Referral Hospital
Mheta, Koy K.
Tanzania, Mwanza
Catholic University of Health and Allied Sciences
Tanzania, Mwanza
Bugando Medical Centre
Jeong, Jiyeon M.
United States, New York
Weill Cornell Medicine
Verweij, Jaco J.
Netherlands, Tilburg
St. Elisabeth Ziekenhuis
Fitzgerald, Daniel W.
United States, New York
Weill Cornell Medicine
Peck, Robert N.
Tanzania, Mwanza
Catholic University of Health and Allied Sciences
Tanzania, Mwanza
Bugando Medical Centre
United States, New York
Weill Cornell Medicine
Statistics
Citations: 10
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1016/j.actatropica.2014.03.001
ISSN:
0001706X
e-ISSN:
18736254
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Tanzania
Participants Gender
Female