Rapid immunochromatographic diagnosis and Rolling Back Malaria--experiences from an African control program.

Malaria is a re-emerging disease in much of Africa. In response, the World Health Organization launched the Roll Back Malaria (RBM) initiative. One of six key principles adopted is the early detection of malaria cases. However, the importance of definitive diagnosis and potential value of field deployment of rapid malaria tests in RBM has been largely ignored. The Lowveld Region of Mpumalanga Province, South Africa, is home to a predominantly non-immune population, of approximately 850000 inhabitants, who are at risk of seasonal Plasmodium falciparum malaria. Malaria treatment in this area is usually only initiated on detection of malaria parasites in the peripheral bloodstream, as many other rickettsial and viral febrile illness mimic malaria. The malaria control programme traditionally relied on light microscopy of Giemsa-stained thick blood films for malaria diagnosis. This review summarizes operational research findings that led to the introduction of rapid malaria card tests for primary diagnosis of malaria throughout the Mpumalanga malaria area. Subsequent operational research and extensive experience over a four-year period since introducing the ICT Malaria Pf test appears to confirm the local appropriateness of this diagnostic modality. A laboratory is not required and clinic staff are empowered to make a prompt definitive diagnosis, limiting delays in initiating correct therapy. The simple, accurate and rapid non-microscopic means now available for diagnosing malaria could play an important role in Rolling Back Malaria in selected areas.

[Postmenopausal endometrial tuberculosis, A report of 2 cases and a literature survey]. / Postmenopousale endometriale tuberkulose. 'n Bespreking van 2 gevalle en 'n literatuuroorsig.

Postmenopausal endometrial tuberculosis is an uncommon condition. Two patients with this disease, 1 of whom also presented with a pyometra, are described. They were the only 2 patients with this disease out of 21742 patients admitted to the Department of Obstetrics and Gynaecology, Tygerberg Hospital. Both were treated with standard antituberculosis drugs for 9 months. No further episodes of postmenopausal bleeding occurred during or directly after treatment, and a follow-up hysteroscopic examination showed a completely atrophic endometrial lining.