title: 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.
abstract: 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.
authors.affiliation: Johns Hopkins School of Medicine, Division of Infectious Diseases, Baltimore, Maryland, USA. lmills@ke.cdc.gov
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Mills
authors.forename: Joseph
authors.initials: J
authors.lastname: Kagaayi
authors.forename: Gertrude
authors.initials: G
authors.lastname: Nakigozi
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Galiwango
authors.forename: Joseph
authors.initials: J
authors.lastname: Ouma
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Shott
authors.forename: Victor
authors.initials: V
authors.lastname: Ssempijja
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Gray
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Wawer
authors.forename: David
authors.initials: D
authors.lastname: Serwadda
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Reynolds
mesh_terms: 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