ABSTRACT
Background : Malaria is a global problem. Rapid diagnosis is essential for effective treatment and reducing mortality and morbidity of malaria. Diagnosis of malariaby peripheral smear is labor-intensive and requires considerable expertise for its interpretation. A rapid test , Advantage MAL card test is based on detection of parasite lactate dehydrogenase (pLDH) and has the ability to differentiate the four major Plasmodium species in 20 minutes. Objectives: 1) To evaluate utility of parasite lactate dehydrogenase for diagnosis of malaria with Advantage Mal card test.2) To compare the results of Advantage Mal card test with peripheral smear findings. Materials and Methods: In this retrospective study, total 5242 patients with malaria like symptoms attending OPD and admitted in wards at Acharya Vinoba Bhave Rural Hospital (AVBRH) from January 2008 to August 2011 were studied. Result: The age of patients ranged from < 1 year- >80 years. The commonest age group affected was 21-30 years. Male to female ratio was 1.04: 1. Prevalence rate of malaria was 101/1000 population in AVBRH. Malarial parasites were detected in PS in10.11% patients (P.falciparum 27.73% , P.vivax 71.32% , mixed infection 0.94%) and in 10.07% patients with Advantage Mal test (P. falciparum 28.03%, P.vivax 71.02%, mixed infection 0.95%). 3 cases of P.vivax and 1case of P.falciparum detected by PS were not detected by Advantage Mal test. 2 cases of P.falciparum detected by Advantage Mal and not by PS. Compared to PS, the Advantage Mal had sensitivity 99.24%, specificity 100%, positive predictive value 100%, negative predictive value was 89.92%. Conclusion: Diagnosis of malaria by detection of pLDH with Advantage Mal card test is simple ,rapid, reliable and cheap method. Results are comparable to blood films. It can detect P.flciparum infection when parasites are sequestered.
Subject(s)
Adult , Age Groups , Clinical Enzyme Tests/methods , Female , Humans , Immunoenzyme Techniques/methods , Lactate Dehydrogenases/analysis , Lactate Dehydrogenases/chemistry , Malaria, Falciparum/diagnosis , Malaria, Vivax/diagnosis , Male , Plasmodium falciparum/enzymology , Plasmodium vivax/enzymology , Sensitivity and Specificity , Young AdultABSTRACT
BACKGROUND: Microscopic examination of peripheral blood smears has been a standard diagnostic test for malarial infection for a long time, but it is labor-intensive and time-consuming. Recently, a rapid diagnostic test for malarial infection containing a dipstick bearing monoclonal antibodies against the intracellular metabolic enzyme, parasite lactate dehydrogenase (pLDH), was introduced (DiaMed OptiMAL(epsilon)). We evaluated the usefulness of the OptiMAL test in malaria diagnosis by comparing with a microscopic examination of peripheral blood smears. METHODS: Fifty-eight (initial 44 and follow-up 14) whole blood samples were obtained from 44 patients who were suspected of having malarial infection. After 1 drop of whole blood reacted with the dipstick, band numbers and positions on the dipsticks determined the results. All results were compared to those of microscopic examination findings. RESULTS: The OptiMAL test revealed 100% sensitivity and specificity by comparing with the microscopic examination. The intensity of stained bands showed positively correlated with the severity of parasitemia. The OptiMAL test revealed a more rapid negative conversion than the microscopic examination after treatment. CONCLUSIONS: The OptiMAL test is a simple, rapid and accurate test for diagnosis of malarial infection; moreover, it is good tool for monitoring after treatment.