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| 1 | Malaria over-diagnosis in Cameroon:diagnostic accuracy of Fluorescence and Staining Technologies(FAST)Malaria Stain and LED microscopy versus Giemsa and bright field microscopy validated by polymerase chain reaction显示文摘Background:Malaria is a major world health issue and its continued burden is due,in part,to difficulties in the diagnosis of the illness.The World Health Organization recommends confirmatory testing using microscopy-based techniques or rapid diagnostic tests(RDT)for all cases of suspected malaria.In regions where Plasmodium species are indigenous,there are multiple etiologies of fever leading to misdiagnoses,especially in populations where HIV is prevalent and children.To determine the frequency of malaria infection in febrile patients over an 8-month period at the Regional Hospital in Bamenda,Cameroon,we evaluated the clinical efficacy of the Flourescence and Staining Technology(FAST)Malaria stain and ParaLens AdvanceTM microscopy system(FM)and compared it with conventional bright field microscopy and Giemsa stain(GS).Methods:Peripheral blood samples from 522 patients with a clinical diagnosis of“suspected malaria”were evaluated using GS and FM methods.A nested PCR assay was the gold standard to compare the two methods.PCR positivity,sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)were determined.Results:Four hundred ninety nine samples were included in the final analysis.Of these,30 were positive via PCR(6.01%)with a mean PPV of 19.62%and 27.99%for GS and FM,respectively.The mean NPV was 95.01%and 95.28%for GS and FM,respectively.Sensitivity was 26.67%in both groups and specificity was 92.78%and 96.21%for GS and FM,respectively.An increased level of diagnostic discrepancy was observed between technicians based upon skill level using GS,which was not seen with FM.Conclusions:The frequency of malarial infections confirmed via PCR among patients presenting with fever and other symptoms of malaria was dramatically lower than that anticipated based upon physicians’clinical suspicions.A correlation between technician skill and accuracy of malaria diagnosis using GS was observed that was less pronounced using FM.Additionally,FM increased the specificity and improved the PPV,suggesting this relatively low cost approach could be useful in resource-limited environments.Anecdotally,physicians were reluctant to not treat all patients symptomatically before results were known and in spite of a negative microscopic diagnosis,highlighting the need for further physician education to avoid this practice of overtreatment.A larger study in an area with a known high prevalence is being planned to compare the two microscopy methods against available RDTs. | Sean M.Parsel Steven A.Gustafson Edward Friedlander Alexander A.Shnyra Aderosoye J.Adegbulu Ying Liu Nicole M.Parrish Syed A.Jamal Eve Lofthus Leo Ayuk Charles Awasom Carolyn J.Henry Carole P.McArthur | 2017 | Infectious Diseases of Poverty2017，6，1： | 2 |
| 2 | Pattern of liver enzyme elevations in acute ST - elevation myocardial in- farction显示文摘 | LOFTHUS D M STEVENS S R ARMSTRONG P W | 2012 | Coron Artery Dis2012，23，1： | 1 |
| 3 | Consequences of hip fracture on activities of daily life and residential needs 显示文摘 | Osnes EK Lofthus CM Meyer HE | 2004 | Osteoporosi int2004，15，： | 1 |
| 4 | 查看详情显示文摘 | Lofthus A Krulenie P H | | 0，，： | 1 |
| 5 | More postoperative femoral fractures with the Gamma nail than the sliding screw plate in the treatment of trochanteric fractures 显示文摘 | Osnes EK Lofthus CM Fslch JA | 2001 | Acta Orthop Scand2001，6，： | 1 |
| 6 | More postoperative femoral fractures with the Gamma nail than the sliding screw plate in the treatment of trochanteric fractures显示文摘 | Osnes E K Lofthus C M Falch J A | 2001 | Acta Orthop Scand2001，72，： | 1 |
| 7 | Pattern of liver enzyme elevations in acute ST-elevation myocardial infarction显示文摘 | Lofthus DM Stevens SR Armstrong PW | 2012 | Coron Artery Dis2012，23，1： | 1 |
| 8 | Epidemiology of hip fractures in Oslo,Norway显示文摘 | Lofthus CM Osnes EK Falch JA | | 0，，05： | 1 |
| 9 | Epidemiology of hip fractures in Oslo,Norway显示文摘 | Lofthus CM Osnes EK Falch JA | 2001 | Bone2001，29，： | 1 |
| 10 | The spectrum of molecular nitrogen显示文摘 | Lofthus A Krupenie P H | 1977 | Journal of Physical and Chemical Reference Data1977，6，： | 1 |
| 11 | More postoperative femoral fractures with the Gamma nail than the sliding screw plate in the treatment of trochanteric fractures 显示文摘 | Osnes EK Lofthus CM Fslch JA | 2001 | Acta Orthop Stand2001，6，： | 1 |
| 12 | More postoperative femoral fractures with the Gamma nail than the sliding screw plate in the treatment of trochanteric fractures 显示文摘 | Osnes EK Lofthus CM Fslch JA | 2001 | Acta Orthop Scand2001，6，： | 1 |
| 13 | More postoprperation femoral fractures with the Gamma nail than the sliding screw plate in the treatment of trochanteric fractures 显示文摘 | Osnes EK Lofthus CM Falch JA | 2001 | Acta Orthop Scand2001，72，： | 1 |
| 14 | More postoperative femoral fractures with the Gamma nail than the sliding screw plate in the treatment of trochanteric fractures显示文摘 | Osnes EK Lofthus CM Falch JA | 2001 | Acta Orthop Scand2001，72，3： | 1 |
| 15 | More postoperative femoral fractures with the Gamma nail than the sliding screw plate in the treatment of trochanteric fractures显示文摘 | Osnes EK Lofthus CM Fslch JA | 2001 | Acta Orthop Scand2001，6，： | 1 |
| 16 | More postoperative femoral fractures with the Gamma nail than the sliding screw plate in the treatment of trochanteric fractures 显示文摘 | OSNES EK LOFTHUS CM FALCH JA | 2001 | Acta Orthop Stand2001，6，： | 1 |
| 17 | Consequences of hip fracture on activities of daily life and residential needs显示文摘 | Osnes EK Lofthus CM Meyer HE | 2004 | Osteoporos Int2004，15，7： | 1 |
| 18 | Bacteremia following sub- gingival irrigation and scaling and root planning 显示文摘 | Lofthus JE Waki MY Jolkovsky DL | 1991 | J Periodon1991，62，10： | 1 |
| 19 | More postoperative femoral fractures with the Gamma nail than the sliding screw plate in the treatment of trochanteric fractures 显示文摘 | Osnes EK Lofthus CM Fslch JA | 2001 | Acta Orthop Scand2001，6，： | 1 |
| 20 | More postoperative femoral fractures with the gamma nail than the sliding screw plate in the treatment of trochanteric fractures 显示文摘 | Osnes EK Lofthus CM Fslch JA | 2001 | Acta Orthop Scand2001，6，： | 1 |
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