ABSTRACT
The conventional peripheral blood film method used to diagnose malaria is characterized by low sensitivity in scanty parasitaemia and can be time consuming when required to rule out infection. The Quantitative Buffy Coat (QBC) method has been proposed to be quicker and more sensitive. We conducted a malaria survey in April 1992 among school-children in Kisumu (holoendemic) and Webuye (hypoendemic) areas of Western Kenya. Peripheral blood samples were examined by thick blood smear (TBS) stained with Giemsa solution, and by the QBC method. A total of 360 paired samples were analyzed. There were 175 (49%) positive TBS and 201 (56%) positive QBC. Of the 185 TBS classified as negative, 30 (16%) were positive by QBC. When parasite density by TBS was > or = 100/300 WBCs, the sensitivity of QBC was 100%. Overall sensitivity for QBC was 98%, with a specificity of 84%. Negative predictive value for the QBC was 98%, and had a calculated accuracy of 92%. It took an average of 44 minutes to process a TBS and a further average of 2.6 minutes to examine a negative TBS. For the QBC the mean time to process and to examine was 7.09 and 1.04 minutes respectively. We conclude that the QBC is quicker, with high sensitivity, and will prove useful in clinical and epidemiological screening, especially when parasitaemia is low.
Subject(s)
Malaria/blood , Mass Screening/methods , Azure Stains , Child , Child, Preschool , False Negative Reactions , False Positive Reactions , Health Surveys , Humans , Kenya/epidemiology , Malaria/epidemiology , Malaria/parasitology , Malaria/prevention & control , Parasitology/methods , Sensitivity and Specificity , Seroepidemiologic Studies , Time FactorsABSTRACT
In preparation for field studies of transmission-blocking malaria vaccines, a study was carried out to determine whether P. falciparum infections obtained in An. gambiae blood-fed at 16.00 hours were quantitatively similar to infections obtained at 23.00 hours. Using a group of children aged 5-12 years from villages at Ahero, near Kisumu in Kenya, 71/74 (96%) of whom were found to be positive for P.falciparum parasitaemia, one batch of fifty colony-bred An.gambiae females were fed on volunteers at 16.00 hours and another batch at 23.00 hours. No statistically significant differences were found in the proportions of mosquitoes becoming infected, the numbers of children infecting mosquitoes or the mean numbers of malaria oocysts developing in mosquitoes blood-fed at the different times. Because mosquito infections obtained by day (16.00 hours) are equivalent in quantity to those obtained at night (23.00 hours), experimental infections can be carried out in the afternoon, when it is most convenient, rather than during the night.
Subject(s)
Anopheles/parasitology , Circadian Rhythm , Insect Vectors/parasitology , Malaria, Falciparum/transmission , Plasmodium falciparum/physiology , Animals , Blood/parasitology , Chi-Square Distribution , Child , Child, Preschool , Female , Humans , Malaria, Falciparum/blood , Male , Parasite Egg CountABSTRACT
The sensitivity of Plasmodium falciparum to chloroquine was studied in 140 children in two locations in Western Kenya. The standard WHO in vivo field test was used and chloroquine phosphate 25 mg base/kg administered in divided doses over three days. In one area 13.2% of cases had recrudescent parasitaemias, while in the other area 8.2% of infections were resistant, with 3.5% having an RII pattern. The remaining isolates were sensitive to chloroquine. Further in vivo and in vitro tests in the region are needed to document the extent and level of resistance.
