Bedside diagnosis of imported malaria using the Binax Now malaria antigen detection test

TY - JOUR

T1 - Bedside diagnosis of imported malaria using the Binax Now malaria antigen detection test

AU - Wiese, Lothar

AU - Bruun, Brita

AU - Baek, Leif

AU - Friis-Møller, Alice

AU - Gahrn-Hansen, Bente

AU - Hansen, Joanna

AU - Heltberg, Ole

AU - Højbjerg, Tove

AU - Hornstrup, Maren Kathrine

AU - Kvinesdal, Birgit

AU - Gomme, Grethe

AU - Kurtzhals, Jørgen

N1 - Keywords: Animals; Biological Markers; Chromatography; Clinical Competence; Diagnostic Errors; Humans; Malaria; Plasmodium; Platelet Count; Point-of-Care Systems; Predictive Value of Tests; Reagent Kits, Diagnostic

PY - 2006

Y1 - 2006

N2 - Malaria may be misdiagnosed in non-endemic countries when the necessary experience for rapid expert microscopy is lacking. Rapid diagnostic tests may improve the diagnosis and may play a role as a bedside diagnostic tool. In a multicentre study we recruited patients suspected of malaria over a period of 14 months. The Binax Now Malaria rapid test was used at the bedside and in the clinical microbiology laboratory. The training of clinical staff was monitored and their experience with the use of the test was recorded. 542 patients were included, 80 of whom had malaria diagnosed by microscopy. The rapid test used at the bedside had a sensitivity of 88% for the detection of P. falciparum compared to 95% when the test was performed in the microbiology laboratory. The risk of technical problems and invalid tests was highest when the test was used at the bedside. The rapid diagnostic test may be useful for the diagnosis of P. falciparum malaria when used by routine laboratory staff, but could lead to misdiagnoses when used at the bedside. Microscopy is still essential in order to identify the few missed diagnoses, to determine the degree of parasitaemia, and to ensure species diagnosis, including mixed infections.

AB - Malaria may be misdiagnosed in non-endemic countries when the necessary experience for rapid expert microscopy is lacking. Rapid diagnostic tests may improve the diagnosis and may play a role as a bedside diagnostic tool. In a multicentre study we recruited patients suspected of malaria over a period of 14 months. The Binax Now Malaria rapid test was used at the bedside and in the clinical microbiology laboratory. The training of clinical staff was monitored and their experience with the use of the test was recorded. 542 patients were included, 80 of whom had malaria diagnosed by microscopy. The rapid test used at the bedside had a sensitivity of 88% for the detection of P. falciparum compared to 95% when the test was performed in the microbiology laboratory. The risk of technical problems and invalid tests was highest when the test was used at the bedside. The rapid diagnostic test may be useful for the diagnosis of P. falciparum malaria when used by routine laboratory staff, but could lead to misdiagnoses when used at the bedside. Microscopy is still essential in order to identify the few missed diagnoses, to determine the degree of parasitaemia, and to ensure species diagnosis, including mixed infections.

U2 - 10.1080/00365540600818011

DO - 10.1080/00365540600818011

M3 - Journal article

C2 - 17148078

SN - 0036-5548

VL - 38

SP - 1063

EP - 1068

JO - Scandinavian Journal of Infectious Diseases

JF - Scandinavian Journal of Infectious Diseases

IS - 11-12

ER -