Malaria misdiagnosis in Uganda--implications for policy change

In Uganda, like in many other countries traditionally viewed as harbouring very high malaria transmission, the norm has been to recommend that febrile episodes are diagnosed as malaria. In this study, the policy implications of such recommendations are revisited. A cross-sectional survey was underta...

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Bibliographic Details
Published in:Malaria journal 2009-04, Vol.8 (1), p.66-66, Article 66
Main Authors: Nankabirwa, Joan, Zurovac, Dejan, Njogu, Julius N, Rwakimari, John B, Counihan, Helen, Snow, Robert W, Tibenderana, James K
Format: Article
Language:English
Subjects:
Animals
Antimalarials - therapeutic use
Causes of
Child, Preschool
Control
Cross-Sectional Studies
Diagnosis
Diagnostic Errors
Diagnostic Tests, Routine - utilization
Female
Fever - drug therapy
Fever - etiology
Health Policy
Humans
Infant
Malaria
Malaria - diagnosis
Malaria - drug therapy
Male
Microscope and microscopy
Microscopy - methods
Parasitemia - diagnosis
Parasitemia - drug therapy
Practice guidelines (Medicine)
Practice Guidelines as Topic
Predictive Value of Tests
Prevention
Sensitivity and Specificity
Uganda - epidemiology
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Summary:In Uganda, like in many other countries traditionally viewed as harbouring very high malaria transmission, the norm has been to recommend that febrile episodes are diagnosed as malaria. In this study, the policy implications of such recommendations are revisited. A cross-sectional survey was undertaken at outpatient departments of all health facilities in four Ugandan districts. The routine diagnostic practices were assessed for all patients during exit interviews and a research slide was obtained for later reading. Primary outcome measures were the accuracy of national recommendations and routine malaria diagnosis in comparison with the study definition of malaria (any parasitaemia on expert slide examination in patient with fever) stratified by age and intensity of malaria transmission. Secondary outcome measures were the use, interpretation and accuracy of routine malaria microscopy. 1,763 consultations undertaken by 233 health workers at 188 facilities were evaluated. The prevalence of malaria was 24.2% and ranged between 13.9% in patients >or=5 years in medium-to-high transmission areas to 50.5% for children
ISSN:1475-2875
1475-2875
DOI:10.1186/1475-2875-8-66