Estimation of Malaria-Attributable Fever in Malaria Test-Positive Febrile Outpatients in Three Provinces of Mozambique, 2018.

Estimation of Malaria-Attributable Fever in Malaria Test-Positive Febrile Outpatients in Three Provinces of Mozambique, 2018.
Am J Trop Med Hyg. 2019 Nov 04;:
Authors: Plucinski MM, Candrinho B, Dimene M, Smith T, Thwing J, Colborn J, Rogier E, Zulliger R
Abstract
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 HRP2 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.
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Source: The American Journal of Tropical Medicine and Hygiene - November 3, 2019 Category: Tropical Medicine Authors: Plucinski MM, Candrinho B, Dimene M, Smith T, Thwing J, Colborn J, Rogier E, Zulliger R Tags: Am J Trop Med Hyg Source Type: research