![]() RDT is being used more and more, regardless of the transmission setting. Globally, it has been estimated that 276 million RDTs for malaria were sold in 2017, and the number rose to 412 million in 2018. However, they may also fail to accurately diagnose for cases with low parasitaemia, and false positives are possible due to cross reactions. ![]() Therefore, RDT is suitable for primary health care institutions with limited facilities and unskilled staff. They do not require any special equipment. RDT uses antibodies to detect one or several parasite-specific antigens in a drop of fresh blood. However, microscopy examination can have a high proportion of false negatives due to the difficult of maintaining the skill of microscopist, especially in the low transmissiong areas. It allows the differentiations of species and stages and the quantification of parasites. Microscopy, as the conventional laboratory method for malaria diagnosis, needs to be conducted by microscopists with adequate training and essential equipment will also be required. Malaria diagnostic tests (MDT), such as microscopy (microscopic examination of Giemsa-stained thick and thin blood films) and rapid diagnostic tests (RDT), are now recommended as routine diagnostic methods by the World Health Organization (WHO) in all suspected malaria patients before treatment. But here were still about 2500 imported cases, and falciparum malaria accounted for more than 85% of them. China continued to make progress on elimination, and reported zero indigenous case since 2017. The global decrease trend appeared to slow from 2014 to 2018. Although the malaria incidence rate declined globally from 71 to 57 cases per 1000 population at risk between 20. , which is transmitted to human through the bites of infected anopheline mosquitoes. Malaria is a parasitic disease caused by Plasmodium spp. ConclusionsĬompared to microscopy and RDT followed by microscopy, RDT strategy had higher effects and higher cost in the setting of malaria elimination. The result of Monte Carlo simulation showed that RDT strategy had higher effects and higher cost than other strategies with a high probability. One-way sensitivity analysis reflected that the result was sensitive to the change in labor cost and two-way sensitivity analysis indicated that the result was not sensitive to the proportion of falciparum malaria. ![]() The results showed that RDT strategy was the most effective (245 cases) but also the most costly (United States Dollar 4.47 million) compared to using microscopy alone (238 cases, USD 3.63 million), and RDT followed by microscopy (221 cases, USD 2.75 million). One-way, two-way, and probabilistic sensitivity analysis were performed to test the robustness of the result. A hypothetical cohort of 300 000 febrile patients were simulated to calculate the total cost and effect of each strategy. Epidemiological data were obtained from local malaria surveillance reports. Data collection was conducted in Jiangsu from September 2018 to January 2019. Based on the joint perspective of health sector and patient, costs data were collected from hospital information systems, key informant interviews, and patient surveys. The effect indicator was defined as the number of malaria cases treated appropriately. ![]() There were three strategies of malaria diagnostic testing evaluated in the model, 1) microscopy, 2) RDT, 3) RDT followed by microscopy. MethodsĪ cost-effectiveness analysis was conducted to compare RDT with microscopy examination for malaria diagnosis, by using a decision tree model. This research aimed to offer evidence for helping decision making on malaria diagnosis strategy. But there are very few economic evaluations to confirm whether RDT was cost-effective in the setting of malaria elimination. As more and more countries approaching the goal of malaria elimination, malaria rapid diagnostic tests (RDT) was recomendated to be a diagnostic strategy to achieve and maintain the statute of malaria free, as it’s less requirments on equipment and experitise than microscopic examination.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |