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dc.contributor.authorPulford, J
dc.contributor.authorKurumop, S
dc.contributor.authorMueller, I
dc.contributor.authorSiba, PM
dc.contributor.authorHetzel, MW
dc.date.accessioned2020-12-17T04:15:45Z
dc.date.available2020-12-17T04:15:45Z
dc.date.issued2018-05-16
dc.identifierpii: 10.1186/s12936-018-2351-0
dc.identifier.citationPulford, J., Kurumop, S., Mueller, I., Siba, P. M. & Hetzel, M. W. (2018). The impact of the scale-up of malaria rapid diagnostic tests on the routine clinical diagnosis procedures for febrile illness: a series of repeated cross-sectional studies in Papua New Guinea. MALARIA JOURNAL, 17 (1), https://doi.org/10.1186/s12936-018-2351-0.
dc.identifier.issn1475-2875
dc.identifier.urihttp://hdl.handle.net/11343/255231
dc.description.abstractBACKGROUND: This paper examines the impact of the scale-up of malaria rapid diagnostic tests (RDT) on routine clinical diagnosis procedures for febrile illness in primary healthcare settings in Papua New Guinea. METHODS: Repeat, cross-sectional surveys in randomly selected primary healthcare services were conducted. Surveys included passive observation of consecutive febrile case management cases and were completed immediately prior to RDT scale-up (2011) and at 12- (2012) and 60-months (2016) post scale-up. The frequency with which specified diagnostic questions and procedures were observed to occur, with corresponding 95% CIs, was calculated for febrile patients prescribed anti-malarials pre- and post-RDT scale-up and between febrile patients who tested either negative or positive for malaria infection by RDT (post scale-up only). RESULTS: A total of 1809 observations from 120 health facilities were completed across the three survey periods of which 915 (51%) were prescribed an anti-malarial. The mean number of diagnostic questions and procedures asked or performed, leading to anti-malarial prescription, remained consistent pre- and post-RDT scale-up (range 7.4-7.7). However, alterations in diagnostic content were evident with the RDT replacing body temperature as the primary diagnostic procedure performed (observed in 5.3 and 84.4% of cases, respectively, in 2011 vs. 77.9 and 58.2% of cases in 2016). Verbal questioning, especially experience of fever, cough and duration of symptoms, remained the most common feature of a diagnostic examination leading to anti-malarial prescription irrespective of RDT use (observed in 96.1, 86.8 and 84.8% of cases, respectively, in 2011 vs. 97.5, 76.6 and 85.7% of cases in 2016). Diagnostic content did not vary substantially by RDT result. CONCLUSIONS: Rapid diagnostic tests scale-up has led to a reduction in body temperature measurement. Investigations are very limited when malaria infection is ruled out as a cause of febrile illness by RDT.
dc.languageEnglish
dc.publisherBIOMED CENTRAL LTD
dc.titleThe impact of the scale-up of malaria rapid diagnostic tests on the routine clinical diagnosis procedures for febrile illness: a series of repeated cross-sectional studies in Papua New Guinea
dc.typeJournal Article
dc.identifier.doi10.1186/s12936-018-2351-0
melbourne.affiliation.departmentMedical Biology (W.E.H.I.)
melbourne.source.titleMalaria Journal
melbourne.source.volume17
melbourne.source.issue1
dc.rights.licenseCC BY
melbourne.elementsid1331712
melbourne.contributor.authorMueller, Ivo
dc.identifier.eissn1475-2875
melbourne.accessrightsOpen Access


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