Bedside diagnosis of imported malaria using the Binax Now malaria antigen detection test

Malaria may be misdiagnosed in non-endemic countries when the necessary experience for rapid expert microscopy is lacking. Rapid diagnostic tests may improve the diagnosis and may play a role as a bedside diagnostic tool. In a multicentre study we recruited patients suspected of malaria over a perio...

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Bibliographic Details
Published in:Scandinavian journal of infectious diseases 2006, Vol.38 (11-12), p.1063-1068
Main Authors: Wiese, Lothar, Bruun, Brita, Bæk, Leif, Friis-Møller, Alice, Gahrn-Hansen, Bente, Hansen, Joanna, Heltberg, Ole, Højbjerg, Tove, Kathrine Hornstrup, Maren, Kvinesdal, Birgit, Gomme, Grethe, Kurtzhals, Jørgen A. L.
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Biomarkers - blood
Chromatography - methods
Clinical Competence
Diagnostic Errors
Human protozoal diseases
Humans
Infectious diseases
Malaria
Malaria - diagnosis
Medical sciences
Parasitic diseases
Plasmodium - isolation & purification
Platelet Count - methods
Point-of-Care Systems
Predictive Value of Tests
Protozoal diseases
Reagent Kits, Diagnostic
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Summary:Malaria may be misdiagnosed in non-endemic countries when the necessary experience for rapid expert microscopy is lacking. Rapid diagnostic tests may improve the diagnosis and may play a role as a bedside diagnostic tool. In a multicentre study we recruited patients suspected of malaria over a period of 14 months. The Binax Now Malaria rapid test was used at the bedside and in the clinical microbiology laboratory. The training of clinical staff was monitored and their experience with the use of the test was recorded. 542 patients were included, 80 of whom had malaria diagnosed by microscopy. The rapid test used at the bedside had a sensitivity of 88% for the detection of P. falciparum compared to 95% when the test was performed in the microbiology laboratory. The risk of technical problems and invalid tests was highest when the test was used at the bedside. The rapid diagnostic test may be useful for the diagnosis of P. falciparum malaria when used by routine laboratory staff, but could lead to misdiagnoses when used at the bedside. Microscopy is still essential in order to identify the few missed diagnoses, to determine the degree of parasitaemia, and to ensure species diagnosis, including mixed infections.
ISSN:0036-5548
1651-1980
DOI:10.1080/00365540600818011