Sensitivity of fever for diagnosis of clinical malaria in a Kenyan area of unstable, low malaria transmission.

ABSTRACT:

Background

Malaria in highland areas of Kenya affects children and adults. Local clinicians include symptoms other than fever when screening for malaria because they believe that fever alone does not capture all cases of malaria.

Methods

Individuals who presented to dispensaries in a highland Kenya site of low, unstable malaria transmission from 2007-2011 with 1 or more of 11 symptoms were tested by microscopy for malaria. Clinical malaria was defined as asexual Plasmodium falciparum infection on peripheral blood smear in an individual with any screening symptom. Asymptomatic P. falciparum infection was assessed in a cohort at ten time points to determine the extent to which symptomatic episodes with parasitaemia might be attributable to baseline (asymptomatic) parasitaemia in the community.

Results

3,420 individuals were screened for malaria, 634?ConclusionIn areas of low, unstable malaria transmission, fever is a sensitive indicator of clinical malaria in children <5 years, but not in older children and adults. Adding headache to fever as screening symptom increases sensitivity of detection in individuals ?5 years old at the cost of decreased specificity. Screening for symptoms in addition to fever may be required to accurately capture all cases of clinical malaria in individuals ?5 years old in areas of low malaria transmission.

SUBMITTER: Mutanda AL 

PROVIDER: S-EPMC4021053 | biostudies-literature | 2014 Apr

REPOSITORIES: biostudies-literature