Utility of a point-of-care malaria rapid diagnostic test for excluding malaria as the cause of fever among HIV-positive adults in rural Rakai, Uganda.
We compared results of a malaria rapid diagnostic test (Binax Now Malaria, Binax-M, Inverness Medical Innovations, Inc., Waltham, MA) performed at rural mobile clinics in Uganda by clinicians evaluating febrile adult HIV patients to thick smear evaluated at a central laboratory by trained microscopists. Two hundred forty-six samples were analyzed, including 14 (5.7%) which were thick-smear positive for falciparum malaria. Sensitivity of Binax-M compared with thick smear was 85.7% (95% CI: 57.2-98.2), specificity 97.8% (95% CI: 94.9-99.3), positive and negative predictive values were 70.6% (95% CI: 44.0-89.7) and 99.1% (95% CI: 96.8-99.9), respectively. The rapid diagnostic test accurately ruled malaria "in or out" at the point-of-care, facilitating appropriate clinical management and averting unnecessary anti-malarial therapy.
Mills
Lisa A
LA
Johns Hopkins School of Medicine, Division of Infectious Diseases, Baltimore, Maryland, USA. lmills@ke.cdc.gov
Kagaayi
Joseph
J
Nakigozi
Gertrude
G
Galiwango
Ronald M
RM
Ouma
Joseph
J
Shott
Joseph P
JP
Ssempijja
Victor
V
Gray
Ronald H
RH
Wawer
Maria J
MJ
Serwadda
David
D
Quinn
Thomas C
TC
Reynolds
Steven J
SJ
D000328:Adult; D005260:Female; D005334:Fever / Q000209:etiology*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008288:Malaria / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D012424:Rural Population; D012680:Sensitivity and Specificity; D014454:Uganda