000			03185nam a22004697a 4500
001			20240611093631.0
003			20240611093631.0
005			20240611094927.0
008			240611b |||||||| |||| 00| 0 eng d
040			_cddc
041			_aEnglish
100			_qPhilip Koliopoulos
245			_aChallenges in Diagnosing and Treating Acutely Febrile Children with Suspected Malaria at Health Care Facilities in the Lake Mwanza Region of Tanzania
260			_aMwanza, Tanzania : _bCatholic University of Health and Allied Sciences [CUHAS-Bugando] : _c2023
300			_aPages 01-07
300			_aIncludes References
490			_vAm J Trop Med Hyg. 2024 Feb; 110(2): 202–208.
520			_aAbstract: Acute febrile diseases transmitted by mosquitos are a diagnostic challenge for pediatricians working in sub-Saharan Africa. Misclassification due to the lack of rapid, reliable diagnostic tests leads to the overuse of antibiotics and antimalarials. Children presenting with acute fever and suspected of having malaria were examined at health care facilities in the Mwanza Region of Tanzania. The sensitivity and specificity of blood smear microscopy and malaria rapid diagnostic tests that targeted histidine-rich protein 2 and Plasmodium lactate dehydrogenase were compared with a multiplex reverse transcriptase-polymerase chain reaction (PCR)–ELISA. Six hundred ninety-eight children presented with acute fever and met the criteria for inclusion; 23% received antibiotics and 23% received antimalarials prior to admission. Subsequently, 20% were confirmed by PCR to have Plasmodium falciparum infection. Blood smear microscopy exhibited 33% sensitivity and 93% specificity. The malaria rapid test provided 87% sensitivity and 98% specificity in detecting acute malaria infections. Only 7% of malaria-negative children received antimalarials at Sengerema Designated District Hospital when treatment was guided by the results of rapid testing. In contrast, 75% of malaria-negative patients were treated with antimalarial drugs at health facilities that used blood smears as the standard diagnostic test. Misclassification and premedication of nonmalarial, febrile illnesses contribute to the emergence of antimalarial and antimicrobial resistance. The incorporation of malaria rapid diagnostic tests into the clinical routine translated into improved treatment and a significant reduction in antimalarial drug prescriptions.
600			_xMalaria
600			_xChildren
700			_qNeema Kayange
700			_q Christian Jensen
700			_qBritta Gröndahl
700			_qJana Eichmann
700			_qTim Daniel
700			_qFlorian Huth
700			_qTill Eckert
700			_qNele Klamm
700			_qMarlene Follmann
700			_qGrey Carolina Medina-Montaño
700			_qAdolfine Hokororo
700			_qLeah Pretsch
700			_qJulia Klüber
700			_qChristian Schmidt
700			_q Antke Züchner
700			_qMarylyn M. Addo
700			_qBernard Okamo
700			_qStephen E. Mshana
700			_qStephan Gehring
856			_u10.4269/ajtmh.23-0254 _y10.4269/ajtmh.23-0254
942			_2ddc _cVM _n0
999			_c28053 _d28053