title: Evaluation of alternative diagnostic techniques for diagnosis of cerebral malaria in a tertiary referral hospital in Bangladesh.
abstract: Five alternative techniques for diagnosis of malaria were evaluated in 124 clinically diagnosed cerebral malaria cases admitted in a tertiary hospital in Bangladesh. Clinical diagnosis of cerebral malaria was done by WHO criteria. The tests were conventional routine malaria microscopy; prolonged microscopy; dipstick antigen capture assay (Para Sight TM-F test); pigments in peripheral leucocytes and routine microscopy repeated at 12 hours interval. First four tests were done at 0 hours of hospital admission and repeat routine microscopy was added at 12 hours interval. Diagnostic capability of the test was 64%, 65%, 69%, 27% and 63% respectively. None of the tests except pigments in peripheral leucocytes was superior at initial evaluation. Only the dipstick test added 5% more diagnostic possibility compared with routine microscopy as standard. Stratification of diagnostic capability in different ways improved diagnosis 15% and 11% in smear negative cases by dipstick and prolonged microscopy respectively. It was increased by 50% (5/10 patients) with dipstick test in the smear negative patients with history of anti-malarials prior to hospital admission.
authors.affiliation: Bangladesh Institute of Tropical and Infectious Diseases, Chittagong, Bangladesh.
authors.forename: M A
authors.initials: MA
authors.lastname: Hossain
authors.forename: S
authors.initials: S
authors.lastname: Afroj
authors.forename: M R
authors.initials: MR
authors.lastname: Rahman
authors.forename: E B
authors.initials: EB
authors.lastname: Yunus
authors.forename: R
authors.initials: R
authors.lastname: Samad
authors.forename: Z H
authors.initials: ZH
authors.lastname: Asna
authors.forename: S
authors.initials: S
authors.lastname: Akter
authors.forename: M A
authors.initials: MA
authors.lastname: Faiz
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000953:Antigens, Protozoan; D001459:Bangladesh; D001927:Brain Diseases / Q000150:complications / Q000175:diagnosis*; D002648:Child; D016054:DNA, Protozoan; D019937:Diagnostic Techniques and Procedures / Q000295:instrumentation*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D016779:Malaria, Cerebral / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000469:parasitology; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D021261:Parasitic Sensitivity Tests; D010963:Plasmodium falciparum / Q000302:isolation & purification*; D011933:Reagent Kits, Diagnostic; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D000953:Antigens, Protozoan; D016054:DNA, Protozoan; D011933:Reagent Kits, Diagnostic