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Utility of a point-of-care malaria rapid diagnostic test for excluding malaria as the cause of fever among HIV-positive adults in rural Rakai, Uganda.

Mills LA, Kagaayi J, Nakigozi G, Galiwango RM, Ouma J, Shott JP, Ssempijja V, Gray RH, Wawer MJ, Serwadda D, Quinn TC, Reynolds SJ

Johns Hopkins School of Medicine, Division of Infectious Diseases, Baltimore, Maryland, USA. lmills@ke.cdc.gov

We compared results of a malaria rapid diagnostic test (Binax Now Malaria, Binax-M, Inverness Medical Innovations, Inc., Waltham, MA) performed at rural mobile clinics in Uganda by clinicians evaluating febrile adult HIV patients to thick smear evaluated at a central laboratory by trained microscopists. Two hundred forty-six samples were analyzed, including 14 (5.7%) which were thick-smear positive for falciparum malaria. Sensitivity of Binax-M compared with thick smear was 85.7% (95% CI: 57.2-98.2), specificity 97.8% (95% CI: 94.9-99.3), positive and negative predictive values were 70.6% (95% CI: 44.0-89.7) and 99.1% (95% CI: 96.8-99.9), respectively. The rapid diagnostic test accurately ruled malaria "in or out" at the point-of-care, facilitating appropriate clinical management and averting unnecessary anti-malarial therapy.

Published 12 January 2010 in Am J Trop Med Hyg, 82(1): 145-7.
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