Diagnosis of malaria parasitemia in children using a rapid diagnostic test

Aim: This cross-sectional study was conducted to evaluate the diagnostic performance of a new rapid immunochromatographic test named “Paracheck pf” in the diagnosis of malaria in Nigerian children.Materials and Methods: A total of 380 Nigerian children aged between 6 and 59 months who presented at the University of Nigeria Teaching Hospital (UNTH) Enugu with fever and no obvious focus of any other infection were consecutively recruited. Malaria parasitemia was determined using simple microscopy and “Paracheck pf”.Results: “Paracheck pf” has the following diagnostic performance characteristics: Sensitivity of 82%, specificity of 91.5%, negative predictive value of 91.5%, positive predictive value of 82%, a strong positive correlation between parasite density and test sensitivity, and a detection limit of 397 parasites/ml.Conclusions: The test is, therefore, recommended for the use in Nigerian children aged between 6 and 59 months in Enugu for the diagnosis of malaria, but negative results should be cautiously interpreted in infants because symptomatic malaria may occur in these children at parasite densities as low as 100/ml

Diagnosis of Plasmodium falciparum malaria in children using the immuno-chromatographic diagnostic technique

Background: Children under five years of age constitute the “at risk” population for fatal complications of P. falciparum malaria infection. Early diagnosis and prompt treatment are key features in the current Roll Back Malaria Programme.Objective: To assess the diagnostic performance of the Immunochromatographic test (ICT) in the rapid diagnosis of falciparum malaria infection in children aged less than five years with a presumptive clinical diagnosis of malaria.Method: This prospective study was conducted at the Children Emergency Room of the Lagos University Teaching Hospital between January and October 2001. Febrile children aged less than five years and were suspected to have malaria, were enrolled. Blood samples from all patients were tested using the ICT-Malaria P f Ò test kit as well as the conventional blood film microscopy after Giemsa staining. Results: The results showed that the diagnosis of falciparum malaria was achieved within eight minutes using the ICT-Malaria P f Ò test kit. The sensitivity of the test kit was 69.6 percent while the specificity was 98.4 percent. However, among patients with severe malaria, the ICT had a sensitivity of 90.3 percent. The test kit was unable to detect antigenaemia at parasite density below 400/ml. An increase in body temperature was associated with higher rate of ICT test positivity.Conclusion: The low sensitivity of the ICT technique obtained in this study makes it a poor screening tool for the routine diagnosis of falciparum malaria in children aged 0-5yrs. It may be useful in the rapid diagnosis of suspected severe malaria in febrile children. The high cost of the test kit is likely to prove a major limitation to its widespread use. Nigerian Journal of Paediatrics Vol. 31(3) 2004: 71-7

Comparison of dynabeads and capcellia methods with facscount for the estimation of CD4 T-lymphocyte levels in HIV/AIDS patients in Lagos, Nigeria

Objective: To compare the efficacy of the Capcellia assay and the Dynabeads technique against the FACScount technique in the estimation of CD4 T-lymphocytes within a Nigerian setting. Design: Prospective study.Setting: Urban area in Nigeria. Subjects: Ninety seven subjects (51 HIV seronegative and 46 HIV seropositive adults)seen in the blood banks and two out patient clinics in Lagos within the study period. Main Outcome Measures: Dynadeads technique with a higher correlation coefficient is a feasible alternative to the FACScount method. Results: There was an overall correlation coefficient of r = 0.75 for CD4 cell counts as determined by the Dynabeads technique in comparison with the FACScount method. Also, an overall correlation coefficient of r = 0.17 for CD4 cell counts as determined by the Capcellia technique against the FACScount method. Conclusion: Dynabeads technique is simple to carry out and cheaper in terms of demand for human expertise and infrastructural requirements than the FACScounts. Therefore, it was recommended for use in the laboratory for monitoring of ARV therapy in Nigeria and any other resource poor country. East African Medical Journal Vol. 83(4) 2006: 105-11

Changes in Serum Proteins and Creatinine levels in HIV Infected Nigerians

Immune dysregulation in terms of hypergammaglobulinaemia and hypogammaglobulinaemia was part of definition of immunodeficiency that characterized AIDS. This results in either raised level of total plasma/serum protein or low level of plasma/serum protein depending on which component of immune dysregulation predominates. This study examined the level of total serum proteins and globulins in HIV infected Nigerians. 64 patients with HIV infection and 10 apparently healthy subjects were recruited from 3 hospitals in Lagos Metropolis. They were examined for the presence of TB and malaria. Serum total protein, albumin and creatinine levels were determined using commercially available kits while the globulin level was computed. Level of immunodeficiency was also determined by CD4+ cell count, using the FACS count method. Data obtained from the patients were compared with values obtained from 10 healthy controls; using appropriate statistical tests on EPI-INFO V 6.0. Results showed that hypergammaglobulinaemia is the major immune dysregulation found with globulin level of 7.4g/d1 as compared with 2.9g/d1 in healthy control though it was not statistically significant. Total serum protein was also higher in HIV infected patients than the controls. The serum globulin was found to correlate negatively with CD4 cell count (r = -0.28, P = 0.0067). Serum creatinine appears not to differ significantly between control and infected patients although the creatinine levels has a positive correlation to plasma globulin levels (r = 0.45, p = 0.001). In conclusion hypergammaglobulinaemia was found to be common in HIV infected Nigerians. This was associated with raised level of plasma creatinine. KEY WORDS: Serum proteins, Creatinine, Albumin, Globulin and HIV Nigerian Journal of Health and Biomedical Sciences Vol.3(2) 2004: 69-7