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Investigation of the efficacy of two rapid assessment techniques (Optimal 1 and SD-Bioline) for the diagnosis of malaria in rural areas of Nigeria

P.U. Agomo, V.N. Asianya, S.K. Akindele, C.O. Agomo, M.O. Akinyele, T.A. Adewole, U.T. Igbasi, R. C Anyanwu, K.N Egbuna

 

Abstract

We had previously studied the efficacy of three new techniques-Para Sight F, (PSF), Immunochromatographic Test (ICT) and Quantitative Buffy Coat (QBC) – as possible replacements for the time-consuming microscopy in the diagnosis of malaria. Two more rapid assessment techniques (the Optimal 1 and SD-BIOLINE) were recently introduced into Nigeria and claimed to exhibit high sensitivity and specificity. Optimal 1 was particularly claimed to distinguish between P falciparum, P. malariae, P ovale and P. vivax. We have in this work evaluated the efficacy of both the Optimal 1 and SD-Bioline in 240 patients from Ibafo and Magboro Communities in Obafemi-Owode LGA of Ogun State, Nigeria. Results showed that with regard to the detection of P. falciparum, Optimal 1 gave a sensitivity, specificity, positive and negative predictive values of 63.95%, 92.20%, 82.1% and 82.1% respectively, while the SD-Bioline gave 54.84%, 42.9%, 68.0% and 68.0% respectively. In retrospect, the sensitivities shown by 3 other techniques (ICT, PSF and QBC) investigated by us were 88.63, 89.95 and 87.6% respectively. Their specificities on the other hand were 94.60, 91.17, 94.70% respectively. The main advantage of the rapid Optimal 1 technique is that it was able to detect P. malariae which microscopy also detected in three patients. The SD-BIOLINE gave the worst comparative result and could not be recommended for use in Nigeria. This work in conclusion has shown that Optimal 1 could be useful in the rapid diagnosis of the various species of Plasmodium in Nigeria provided the patients could afford the test.

(Af. J. of Clinical and Experimental Microbiology: 2003 4(1): 6-13)

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Evaluation of the OptiMAL Test for Rapid Diagnosis of Malaria

IOA Ujah, EI Ikeh, RH Glew, DJ Vanderjagt

 

Abstract

This study evaluated the ability of a newly developed rapid test for laboratory diagnosis of malaria. OptiMAL is a rapid test that utilizes a dipstick coated with monoclonal antibodies against the intracellular parasite dehydrogenase (PLDH). The differentiation of Plasmodium species is based on antigenic differences between the PLDH forms. Blood samples from 62 of clinically diagnosed patients were examined using the microscopy of Giemsa-stained blood films and the OptiMAL test. The blood films indicated that 27% of the patients were positive for P.falciparum (including one case of mixed infection with P. malariae), while the OptiMAL test recorded 34% for P. falciparum. The OptiMAL test failed to diagnose malaria at concentrations less than 100 per microliter of blood, while those missed by microscopy may be due to sequestration of the parasite coupled with low parasite density. The OptiMAL test was modified by using fingerprick instead of venepuncture and this simplifies the test both in terms of cost and trained personnel. There was no significant difference between the two methods (x2 = 1.513;P>0.05), but the OptiMAL test has the advantages of being faster, requires almost no specialized laboratory experience and extremely sensitive and specific even in field situations. We conclude that the OptiMAL test is an effective tool for the rapid diagnosis of malaria.

(Af. J. of Clinical and Experimental Microbiology: 2003 4(1): 14-17)

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Malaria morbidity amongst hospital workers in Ilorin

A.O. Awoyemi

 

Abstract

A study of malaria as a cause of morbidity among the staff of the University of Ilorin Teaching Hospital, Ilorin, Nigeria was carried out from August to October 2001. Patients attending a community based Health Centre was used as control. Malaria accounted for 43.0% of illnesses among the workers and 36.7% in the general public. Malaria was responsible for nearly two-thirds of sickness absence and for 48.6% of days lost due to illnesses. Also the disease was responsible for 50 percent or more of sickness absence among all categories of workers when analyzed by occupations. These findings show that malaria could disrupt the health care delivery of a country since it could affect even health workers. By extension too, it could result in the disruption of the economic activities of the country and result in low productivity if not effectively controlled. It I therefore recommended that all efforts at effective controlling malaria should be put in place in Nigeria.

(Af. J. of Clinical and Experimental Microbiology: 2003 4(1): 18-23)

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Parasitic dermatoses as seen at the University of Benin Teaching Hospital (UBTH), Benin City In Nigeria

Abstract

 

The epidemiology and associated risk factors for parasitic infections causing dermatologic lesions were studied retrospectively over a five year period (1993-1998) in Benin City Nigeria. The study population comprised one hundred and fifty six patients (84 males and 72 females) out of a total of 1665 patients who attended the dermatology clinic at the (UBTH) during the period of study. Dermatological manifestations of diagnosed parasitic infections were recorded and related to the occurrence of parasite species in microscopically studied specimens collected form patients. 9.4% of patients seen presented with various skin diseases of parasitic origin. The most prevalent parasitic disease seen was scabies 115 (73.7%); others were onchodermatitis 16(10.3%), myasis 11(7.1%), wuchereriasis (elephantiasis) 9(5.8%), cutaneous larva migrans 3(1.9) and pediculosis pubis 2(1.3%). Infection was prevalent in all age groups. Overall prevalence revealed that patients aged 15 years and below had the highest infection rate of 60 (38.5%) while the lowest infection occurred among those who were aged 60 years and above. Dermatologic parasitoses presented as chronic persistent infections, which were sometimes severe especially in children. Infection rate was significantly higher among males (53.8%) than females (46.2%) (P<0.05), symptoms included generalized skin rashes, for most infections, leopard skin in onchodermatitis and marked discomfort and disfigurement in elephantiasis. The major risks associated with these parasitic infections include socioeconomic status, age and human behavioral factors.

(Af. J. of Clinical and Experimental Microbiology: 2003 4(1): 24-30)