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Spatial Simulation of Malarial Infection and it’s Diagnosis by RDK

Author(s): Gamit M and Ratna Trivedi

Malaria diagnosis is carried out by microscopic examination of blood films and suspected should preferably be investigated for confirmation of malaria by Microscopy or Rapid Diagnostic Kit (RDK) so as to ensure full therapeutic dose with appropriate drug to all confirmed cases. The aim of the study was to review the spectrum of disease associated with malaria due to P. vivex and P. falciparum in patients presenting to PHC during May, 2008 to Nov., 2009. Among patients admitted with slide-confirmed malaria, 64% of patients had P.f alciparum, 24% P. vivex, and 10.5% mixed infections. The proportion of malarial admissions attributable to P. vivex raised to 47% (415/887) in children under one year of age. Severe disease was present in 2,634 (22%) inpatients with malaria, with the risk greater among P. vivex (23%[675/2,937]) infections compared to P. falciparum(20%[1,570/ 7,817]; odds ratio [OR] = 1.19 [95%confidence interval (CI) 1.08-1.32], p = 0.001), and greatest in patients with mixed infections (31% [389/1,273]); overall p < 0.0001. Severe anemia (hemoglobin < 5 g/dl) was the major complication associated with P. vivex, accounting for 87%(589/675) of severe disease compared to 73%(1,144/1,570) of severe manifestations with P. falciparum (p < 0.001). Pure P. vivex infection was also present in 78 patients with respiratory distress and 42 patients with coma. In total 242 (2.0%) patients with malaria died during admission: 2.2%(167/7,722) with P. falciparum, 1.6%(46/2,916)with P. vivex, and 2.3%(29/1260)with mixed infections (p = 0.126). Between August and November 2007, 1004 patients aged between 1 and 93 years were enrolled in the study. Slide microscopy (the reference standard) diagnosed 213 P.vivex mono infections, 98 P. falciparum mono-infections and no malaria in 650 cases.

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