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1.
Ministério da Saúde–MISAU, Instituto Nacional de Estatística–INE, ICF, 2018. Inquérito de Indicadores de Imunização, Malária e HIV/SIDA em Moçambique–IMASIDA, 2015. Maputo, Moçambique: MISAU/Moçambique, INE, and ICF.
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MISAU, 2017. Normas de Tratamento de Malária em Moçambique. Maputo, Moçambique: DNSP.
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Plucinski MM, Rogier E, Dimbu R, Fortes F, Halsey ES, Aidoo M, Smith T, 2019. Performance of antigen concentration thresholds for attributing fever to malaria among outpatients in Angola. J Clin Microbiol 57: e01901–e01918.
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Candrinho B et al. 2019. Quality of malaria services offered in public health facilities in three provinces of Mozambique: a cross-sectional study. Malaria J 18: 162.
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Plucinski MM, Candrinho B, Dimene M, Colborn J, Lu A, Nace D, Zulliger R, Rogier E, 2019. Assessing performance of HRP2 antigen detection for malaria diagnosis in Mozambique. J Clin Microbiol 57: e00875–19.
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MISAU, INE, 2016. Inquérito de Indicadores de Imunização, Malária e HIV/SIDA em Moçambique (IMASIDA) 2015: Relatório de Indicadores Básicos. Maputo, Moçambique: INE.
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Plucinski MM et al. 2018. Screening for pfhrp2/3-deleted Plasmodium falciparum, non-falciparum, and low-density malaria infections by a multiplex antigen assay. J Infect Dis 219: 437–447.
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Rogier E et al. 2017. Bead based immunoassay allows sub-picogram detection of histidine-rich protein 2 from Plasmodium falciparum and estimates reliability of malaria rapid diagnostic tests. PLoS One 12: e0172139.
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Plucinski MM, McElroy PD, Dimbu PR, Fortes F, Nace D, Halsey ES, Rogier E, 2019. Clearance dynamics of lactate dehydrogenase and aldolase following antimalarial treatment for Plasmodium falciparum infection. Parasit Vectors 12: 293.
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Bisoffi Z, Sirima SB, Menten J, Pattaro C, Angheben A, Gobbi F, Tinto H, Lodesani C, Neya B, Gobbo M, 2010. Accuracy of a rapid diagnostic test on the diagnosis of malaria infection and of malaria-attributable fever during low and high transmission season in Burkina Faso. Malaria J 9: 192.
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| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 546 | 490 | 21 |
| Full Text Views | 911 | 19 | 0 |
| PDF Downloads | 288 | 15 | 0 |
Estimation of Malaria-Attributable Fever in Malaria Test–Positive Febrile Outpatients in Three Provinces of Mozambique, 2018
Mateusz M. Plucinski
Mateusz M. Plucinski
Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia;
United States President’s Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, Georgia;
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United States President’s Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Baltazar Candrinho
Baltazar Candrinho
National Malaria Control Program, Ministry of Health, Maputo, Mozambique;
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Mercia Dimene
Mercia Dimene
National Malaria Control Program, Ministry of Health, Maputo, Mozambique;
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Tom Smith
Tom Smith
Swiss Tropical and Public Health Institute, Basel, Switzerland;
University of Basel, Basel, Switzerland;
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University of Basel, Basel, Switzerland;
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Julie Thwing
Julie Thwing
Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia;
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James Colborn
James Colborn
Clinton Health Access Initiative, Maputo, Mozambique;
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Eric Rogier
Eric Rogier
Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia;
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Rose Zulliger
Rose Zulliger
Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia;
United States President’s Malaria Initiative, Centers for Disease Control and Prevention, Maputo, Mozambique
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United States President’s Malaria Initiative, Centers for Disease Control and Prevention, Maputo, Mozambique
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Like most malaria-endemic countries, Mozambique relies on tabulation of confirmed malaria test–positive febrile patients to track incidence of malaria. However, this approach is potentially biased by incidental malaria parasitemia in patients with fever of another etiology. We compared pan-Plasmodium aldolase and lactate dehydrogenase and Plasmodium falciparum histidine-rich protein 2 (PfHRP2) antigen concentrations measured using a laboratory bead-based assay of samples collected from 1,712 febrile and afebrile patients of all ages in Maputo, Zambézia, and Cabo Delgado provinces. We used a Bayesian latent class model to estimate the proportion of malaria-attributable fevers in malaria test–positive febrile patients. Depending on the antigen, estimated rates of malaria-attributable fever in malaria test–positive febrile patients were 100% in Maputo, 33–58% in Zambézia, and 63–74% in Cabo Delgado. Our findings indicate that most malaria test–positive febrile patients in the three provinces of Mozambique had a fever that was likely caused by the concurrent malaria infection. Counting malaria test–positive febrile patients for estimation of malaria incidence appears to be appropriate in this setting.
- Supplemental Materials (PDF 930 KB)
Author Notes
Authors’ addresses: Mateusz M. Plucinski, Julie Thwing, Eric Rogier, and Rose Zulliger, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: mplucinski@cdc.gov, jthwing@cdc.gov, erogier@cdc.gov, and ymr0@cdc.gov. Baltazar Candrinho and Mercia Dimene, National Malaria Control Program, Ministry of Health, Maputo, Mozambique, E-mails: candrinhobaltazar@gmail.com and merciad40@yahoo.com.br. Tom Smith, Swiss Tropical and Public Health Institute, Basel, Switzerland, E-mail: thomas-a.smith@unibas.ch. James Colborn, Clinton Health Access Initiative, Maputo, Mozambique, E-mail: jcolborn.ic@clintonhealthaccess.org.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Ministério da Saúde–MISAU, Instituto Nacional de Estatística–INE, ICF, 2018. Inquérito de Indicadores de Imunização, Malária e HIV/SIDA em Moçambique–IMASIDA, 2015. Maputo, Moçambique: MISAU/Moçambique, INE, and ICF.
-
2.
MISAU, 2017. Normas de Tratamento de Malária em Moçambique. Maputo, Moçambique: DNSP.
-
3.
Smith T, Schellenberg JA, Hayes R, 1994. Attributable fraction estimates and case definitions for malaria in endemic areas. Stat Med 13: 2345–2358.
-
4.
World Health Organization, 2019. World Malaria Report 2018. Geneva, Switzerland: WHO.
-
5.
Dalrymple U et al. 2019. The contribution of non-malarial febrile illness co-infections to Plasmodium falciparum case counts in health facilities in sub-Saharan Africa. Malar J 18: 195.
-
6.
Vounatsou P, Smith T, Smith A, 1998. Bayesian analysis of two‐component mixture distributions applied to estimating malaria attributable fractions. J R Stat Soc Ser C 47: 575–587.
-
7.
Plucinski MM, Rogier E, Dimbu R, Fortes F, Halsey ES, Aidoo M, Smith T, 2019. Performance of antigen concentration thresholds for attributing fever to malaria among outpatients in Angola. J Clin Microbiol 57: e01901–e01918.
-
8.
Candrinho B et al. 2019. Quality of malaria services offered in public health facilities in three provinces of Mozambique: a cross-sectional study. Malaria J 18: 162.
-
9.
Plucinski MM, Candrinho B, Dimene M, Colborn J, Lu A, Nace D, Zulliger R, Rogier E, 2019. Assessing performance of HRP2 antigen detection for malaria diagnosis in Mozambique. J Clin Microbiol 57: e00875–19.
-
10.
MISAU, INE, 2016. Inquérito de Indicadores de Imunização, Malária e HIV/SIDA em Moçambique (IMASIDA) 2015: Relatório de Indicadores Básicos. Maputo, Moçambique: INE.
-
11.
Plucinski MM et al. 2018. Screening for pfhrp2/3-deleted Plasmodium falciparum, non-falciparum, and low-density malaria infections by a multiplex antigen assay. J Infect Dis 219: 437–447.
-
12.
Rogier E et al. 2017. Bead based immunoassay allows sub-picogram detection of histidine-rich protein 2 from Plasmodium falciparum and estimates reliability of malaria rapid diagnostic tests. PLoS One 12: e0172139.
-
13.
Spiegelhalter D, Thomas A, Best N, Lunn D, 2003. WinBUGS Version 1.4. 2003. Robinson Way, Cambridge: MRC Biostatistics Unit, Institute of Public Health.
-
14.
World Health Organization, 2016. Malaria Rapid Diagnostic Test Performance: Results of WHO Product Testing of Malaria RDTs: Round 7 (2015–2016). Geneva, Switzerland: WHO.
-
15.
Barnwell J, 2009. Implications of Parasite Density Thresholds for Product Testing, Lot-Testing and Positive Control Wells. Geneva, Switzerland: WHO, 39–41.
-
16.
Plucinski MM, McElroy PD, Dimbu PR, Fortes F, Nace D, Halsey ES, Rogier E, 2019. Clearance dynamics of lactate dehydrogenase and aldolase following antimalarial treatment for Plasmodium falciparum infection. Parasit Vectors 12: 293.
-
17.
Bisoffi Z, Sirima SB, Menten J, Pattaro C, Angheben A, Gobbi F, Tinto H, Lodesani C, Neya B, Gobbo M, 2010. Accuracy of a rapid diagnostic test on the diagnosis of malaria infection and of malaria-attributable fever during low and high transmission season in Burkina Faso. Malaria J 9: 192.
-
18.
Dicko A, Mantel C, Kouriba B, Sagara I, Thera MA, Doumbia S, Diallo M, Poudiougou B, Diakite M, Doumbo OK, 2005. Season, fever prevalence and pyrogenic threshold for malaria disease definition in an endemic area of Mali. Trop Med Int Health 10: 550–556.
-
19.
Rogier C, Commenges D, Trape J-F, 1996. Evidence for an age-dependent pyrogenic threshold of Plasmodium falciparum parasitemia in highly endemic populations. Am J Trop Med Hyg 54: 613–619.
-
20.
Mutanda AL, Cheruiyot P, Hodges JS, Ayodo G, Odero W, John CC, 2014. Sensitivity of fever for diagnosis of clinical malaria in a Kenyan area of unstable, low malaria transmission. Malar J 13: 163.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 546 | 490 | 21 |
| Full Text Views | 911 | 19 | 0 |
| PDF Downloads | 288 | 15 | 0 |