title: Malaria diagnosis under field conditions in the Venezuelan Amazon.
abstract: To improve practical, accurate diagnosis of malaria in the Amazon rainforest of Venezuela, two rapid diagnostic tests (RDT) (OptiMAL-IT) and FalciVax) and a laboratory light microscope, used in the field with a battery-operated head lamp as an external light source, were evaluated against the standard laboratory microscope procedure for malaria detection. One hundred and thirty-six Yanomami patients were studied for the presence of malaria parasites. Thirty-three patients (24%) were positive for malaria (Plasmodium falciparum, P. vivax, P. malariae). Twenty-one (64%) of the positive patients had <100 parasites/microl. Both RDTs showed poor sensitivity (24.2% for OptiMAL-IT) and 36.4% for FalciVax) but good specificity (99% both for OptiMAL-IT) and FalciVax). Field and laboratory microscopy showed sensitivities of 94% and 91%, respectively. The kappa coefficient was 0.90, indicating a high agreement between field and laboratory microscopy. We conclude that (i) adequate slide reading cannot be substituted by either of the two RDTs in the Venezuelan Amazon and (ii) the use of a light source such as that described above makes slide reading more feasible than hitherto in remote areas without electricity.
authors.affiliation: Centro Amazónico de Investigación y Control de Enfermedades Tropicales Simon Bolivar (CAICET), Puerto Ayacucho, Venezuela.
authors.forename: W G
authors.initials: WG
authors.lastname: Metzger
authors.forename: S
authors.initials: S
authors.lastname: Vivas-Martínez
authors.forename: I
authors.initials: I
authors.lastname: Rodriguez
authors.forename: J
authors.initials: J
authors.lastname: Gonçalves
authors.forename: E
authors.initials: E
authors.lastname: Bongard
authors.forename: C I
authors.initials: CI
authors.lastname: Fanello
authors.forename: L
authors.initials: L
authors.lastname: Vivas
authors.forename: M
authors.initials: M
authors.lastname: Magris
mesh_terms: D000818:Animals; D006801:Humans; D008288:Malaria / Q000175:diagnosis*; D008853:Microscopy / Q000379:methods / Q000592:standards; D018512:Parasitemia / Q000175:diagnosis*; D010961:Plasmodium / Q000302:isolation & purification*; D011786:Quality Control; D011933:Reagent Kits, Diagnostic / Q000469:parasitology / Q000592:standards*; D012680:Sensitivity and Specificity; D014687:Venezuela / Q000453:epidemiology
chemical_list: D011933:Reagent Kits, Diagnostic