Fulltext

Malaria: how useful are clinical criteria for improving the diagnosis in a highly endemic area?

Genton, B. ; Smith, T. ; Baea, K. ; Narara, A. ; Al-Yaman, F. ; Beck, H.-P ; Hii, J. ; Alpers, M.

In: Transactions of The Royal Society of Tropical Medicine and Hygiene, 1994, vol. 88, no. 5, p. 537-541

Ajouter à la liste personnelle
    Titre
    • Malaria: how useful are clinical criteria for improving the diagnosis in a highly endemic area?
    Auteur
    • Genton, B.. Papua New Guinea Institute of Medical Research, P. O. Box 378, Madang, Papua New Guinea
    • Smith, T.. Swiss Tropical Institute, Socinstrasse 57, Postfach, 4002 Basel, Switzerland
    • Baea, K.. Papua New Guinea Institute of Medical Research, P. O. Box 378, Madang, Papua New Guinea
    • Narara, A.. Papua New Guinea Institute of Medical Research, P. O. Box 378, Madang, Papua New Guinea
    • Al-Yaman, F.. Papua New Guinea Institute of Medical Research, P. O. Box 378, Madang, Papua New Guinea
    • Beck, H.-P. Papua New Guinea Institute of Medical Research, P. O. Box 378, Madang, Papua New Guinea
    • Hii, J.. Papua New Guinea Institute of Medical Research, P. O. Box 378, Madang, Papua New Guinea
    • Alpers, M.. Papua New Guinea Institute of Medical Research, P. O. Box 378, Madang, Papua New Guinea
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Transactions of The Royal Society of Tropical Medicine and Hygiene, 1994, vol. 88, no. 5, p. 537-541. Royal Society of Tropical Medicine and Hygiene
    Autre version électronique
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:299488
    Summary
    To assess the validity of clinical criteria, we investigated 2096 outpatients diagnosed as malaria cases by nurses at a rural health subcentre in a highly endemic area of Papua New Guinea. 73% of the children < 10 years old had a positive blood slide for any species of Plasmodium and 32% had ⩾ 10 000 P. falciparum parasites per μL. For adults the frequencies were 51% and 9%, respectively. Stepwise logistic regression identified spleen size, no cough, temperature, no chest indrawing, and normal stools as significant predictors for a positive blood slide in children; no cough and normal stools predicted a positive blood slide in adults. Fever, no cough, vomiting, and enlarged spleen were significant predictors for a P. falciparum parasitaemia ⩾ 10 000/μL in children; in adults the only predictor was vomiting. In children the association of no cough and enlarged spleen had the best predictive value for a positive blood slide, and a temperature ⩾ 38 °C had the best predictive value for a P. falciparum parasitaemia ⩾ 10 000 μL. In adults, no major symptom had a good predictive value for a positive blood slide but vomiting had the best predictive value for a P. falciparum parasitaemia ⩾ 10 000/μL. When microscopy is not available, these findings can help in areas of high endemicity to determine which patients with a history of fever are most likely to have malaria and, more importantly, for which patients another diagnosis should be strongly considered