ABSTRACT
Introduction/Aim: Malaria is a major public health problem and can lead to fatal consequences within few days if not diagnosed and promptly treated. The aim of this study was to determine the malaria parasite prevalence and assess the performance characteristics of the Partec CyScope® rapid diagnostic test (RDT) in Tole. Experimental Design, Place and Duration of Study: The study was a cross-sectional survey, carried out in Tole, Southwest Cameroon in July 2014. Methodology: A total of 231 children were studied. Information on demographic data, temperature and malaria risk factors was recorded. Capillary blood was collected by finger pricking. Thick and thin blood films were prepared for malaria parasite detection and speciation. Ten μL of blood was added unto the DAPI coated slides and read under the Partec CyScope®. Haemoglobin values were determined. Results and Conclusion: The overall prevalences of malaria parasites, fever and anaemia were 66.2%, 35.9% and 86.6% respectively. Although not statistically significant, malaria parasite prevalence was highest in children aged 1 – 5 years, higher in females, those that had stagnant water and bushes around their homes as well as those who did not use insecticide-treated bed nets and insecticide residual spraying when compared with their respective counterparts. Overall geometric mean parasite density (GMPD) was 3691 (range = 100 - 48000) parasites/μL of blood). GMPD was significantly higher (P = 0.03) in febrile than afebrile children. Prevalence of anaemia was significantly higher (P = 0.01) in malaria positive (68.5%) than negative (45.2%) children. More cases of infections were detected by light microscopy than by Partec CyScope®. The sensitivities and specificities of Partec CyScope® were 87.6% (CI = 81.4-91.1%) and 94.9% (CI = 87.5-98.0%) respectively while the positive and negative predictive values were 97.1% and 79.6% respectively. Partec CyScope® can therefore be used for mass malaria surveillance.
ABSTRACT
Aims: Malaria and soil-transmitted helminth (STH) infections are parasitic diseases afflicting populations that are impoverished and malnourished. The aim of this study was to assess the influence of altitude and urbanisation on Co-infection of malaria and soil-transmitted helminths in Fako Division, South West Cameroon. Study Design/Place and Duration of Study: It was a cross-sectional survey carried out from 2012 to 2014 involving 1138 children aged 4 – 15 years in Fako Division. Methodology: Structured questionnaire was administered to obtain demographic and socioeconomic data. Blood samples were collected by pricking the finger. Malaria parasite prevalence, density and species were determined from Giemsa-stained thick and thin blood smears respectively. Quantitative estimation of helminth eggs was done by Kato-Katz thick smear technique. Based on height above sea level (a.s.l.), the study sites were classified as Lowland (<200 m.a.s.l), Lower middle belt (>200 but ≤ 400 m.a.s.l), Upper middle belt (>400 but ≤600 m.a.s.l.) and Highland (>600 m.a.s.l). The study communities were also classified into rural, semiurban and urban areas. Results: The overall prevalence was 38.1% (433) for malaria, 2.5% (29) for STHs and 0.9% (10) for malaria-STH co-infection. The prevalence of malaria was significantly highest (χ2 = 84.6, P <0.001) in urban areas (52.2%, 263) than in the semi-urban (29.4%, 152) and rural areas (15.4%, 18). Malaria prevalence was significantly highest (χ2 = 123.4, P <0.001) at the lowest altitude (60.5%, 182) and decreased as altitude increased to a minimum of 15.4% (18) at highland (>600 m.a.s.l). Only two species of soil-transmitted STH [Ascaris lumbricoides (1.9%) and Trichuris trichiura (0.6%)] were found. The prevalence of STH was significantly higher (χ2= 33.8, P <0.0001) in rural (13.6%, 16) than urban (0.39%, 2) areas. The prevalence of STH was significantly highest (χ2 = 33.8, P <0.0001) at high altitude (13.6%, 16) than the upper middle-belt (2.0%, 8), lower middle-belt (1.2%, 4) and lowlands (0.7%, 2). The prevalence of co-infection varied significantly (χ2 = 72.2, P <0.0001) with level of urbanisation with the highest level of co-infection occurring in the rural areas (2.6%, 3) and the lowest level in the urban areas (0.2%, 1). Conclusion: Malaria control measures need to be intensified especially in the lowland and urban areas. Deworming campaigns are yielding positive results in Fako Division.
ABSTRACT
Aim: The aim of this study was to determine the prevalence and density of malaria parasites in asymptomatic school children in Mutengene and evaluate the performance characteristics of the ‘CareStartTM Malaria HRP2 pf (CAT NO: G0141, ACCESSBIO)’ rapid diagnostic test (RDT) using light microscopy as a gold standard. Study Design: The study was a cross-sectional survey. Place and Duration of Study: The study was carried out in Mutengene, from February to March, 2013. Methodology: A total of 406 pupils were studied. Demographic data was taken for each child and capillary blood was collected. Blood films were prepared for the assessment of parasite density and speciation. A drop of blood was used on the RDT to determine the malaria status. Results: The mean age at 95% confidence interval (CI) was 8 ± 2 years (range = 4 -15 years) and the overall prevalence of malaria was 39.9% (162) by microscopy. The geometric mean parasite density (GMPD) was 2332.7 parasites/µL (range: 218 - 16000). Only 386 pupils were examined by both methods. More pupils were positive by microscopy (40.9%, CI = 36.1 - 45.9) than by RDT (27.9%, CI = 23.7 - 32.7) and the difference was statistically significant (χ2 = 16.1, P <0.0001). The majority of those detected had high infection (≥ 5000 parasite/µL). Less than 50% of those with low (25.0%, CI = 12.0 - 44.9), moderate (40.7%, CI = 32.24-49.70) and high parasitaemia (75%, CI = 5.00-89.82) were positive by RDT and the difference was significant (χ2 = 10.09, P = 0.006). The RDT showed a low sensitivity of 48.5% (CI = 40.3 – 56.9%) and specificity of 84.0% (CI = 80.0- 88.2%). Conclusion: More research needs to be done on the RDT to improve on its performance characteristics before it could be used in mass surveillance programmes.