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Malaria burden and case management in the Republic of Congo: limited use and application of rapid diagnostic tests results
- Source :
- BMC Public Health, Vol 13, Iss 1, p 135 (2013), BMC Public Health
- Publisher :
- Springer Nature
-
Abstract
- Background There have been few investigations evaluating the burden of malaria disease at district level in the Republic of Congo since the introduction of artemisinin-based combination therapies (ACTs). The main objective of this study was to document laboratory-confirmed cases of malaria using microscopy and/or rapid diagnostic tests (RDTs) in children and pregnant women attending selected health facilities in Brazzaville and Pointe Noire, the two main cities of the country. Secondly, P. falciparum genetic diversity and multiplicity of infection during the malaria transmission season of October 2011 to February 2012 in these areas were described. Methods Three and one health facilities were selected in Brazzaville and Pointe-Noire as sentinel sites for malaria surveillance. Children under 15 years of age and pregnant women were enrolled if study criteria were met and lab technicians used RDT and/or microscopy to diagnose malaria. In order to determine the multiplicity of infection, parasite DNA was extracted from RDT cassette and msp2 P.falciparum genotyped. Results Malaria prevalence among more than 3,000 children and 700 pregnant women ranged from 8 to 29%, and 8 to 24% respectively depending on health center locality. While health workers did not optimize use of RDTs, microscopy remained a reference diagnostic tool. Quality control of malaria diagnosis at the reference laboratory showed acceptable health centre performances. P. falciparum genetic diversity determination using msp2 gene marker ranged from 9 to 20 alleles and remains stable while multiplicity of infection (mean of 1.7clone/infected individual) and parasite densities in clinical isolates were lower than previously reported. Conclusions These findings are consistent with a reduction of malaria transmission in the two areas. This study raises the issue of targeted training for health workers and sustained availability of RDTs in order to improve quality of care through optimal use of RDTs.
- Subjects :
- Adult
medicine.medical_specialty
Pediatrics
Plasmodium falciparum
Time Factors
Adolescent
Republic of Congo
Disease
Young Adult
Cost of Illness
Multiplicity of infection
Pregnancy
Environmental health
Epidemiology
parasitic diseases
Medicine
Humans
Artemisinin
Child
Microscopy
biology
business.industry
Diagnostic Tests, Routine
Public health
lcsh:Public aspects of medicine
Rapid diagnostic tests
Public Health, Environmental and Occupational Health
Infant
lcsh:RA1-1270
biology.organism_classification
medicine.disease
Malaria
One Health
Congo
Child, Preschool
Female
Biostatistics
business
Case Management
medicine.drug
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14712458
- Volume :
- 13
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Public Health
- Accession number :
- edsair.doi.dedup.....82086b4a51fac55941c3b011243e49a5
- Full Text :
- https://doi.org/10.1186/1471-2458-13-135