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NJBMS - Volume 1, Issue 4, April - June 2011

Pages: 212-216
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SIMPLE YET VALUABLE – ANTIGEN DETECTION ICT (IMMUNO CHROMATOGRAPHIC TEST) IN EARLY DIAGNOSIS AND TREATMENT OF COMPLICATED MALARIA IN ENDEMIC AREAS

Author: S.POONGODI @ LAKSHMI , N.PALANIAPPAN

Category: Microbiology

Abstract:

Introduction :

Severe thrombocytopenia and acute renal failure, once considered to be exclusively due to P. falciparum were observed recently in P.vivax infection also. Early diagnosis and appropriate treatment is the basis to prevent complications. Diagnosis , solely based on clinical symptoms is unreliable. Microscopist is not available everywhere and reliability is also questionable. So a simple alternative test is required for the present situation.

Aim

The present study is to compare microscopy with Ag detection ICT during an epidemic and to document ARF and thrombocytopenia with P.vivax infection in endemic area.

Materials and methods

78 patients were screened for malaria during the epidemic from December 2009 and January 2010. Malaria Ag detection ICT was used along side the gold standard microscopy.

Result

Total patients screened = 78 .Positive by thick smear : 23 (30%) i.e., P.vivax-20(26%), P.falciparum 3(4%) Positive by Ag detection ICT : 34 (44%) i.e, P.vivax22(28%) P.falciparum12(15%) Sensitivity (ICT) 95.83%, Specificity (ICT) 79.82%, Thrombocytopenia : P.vivax – 7 out of 22 (32%)P.falciparum – 7 out of 12 (58%) Acute renal failure – P.vivax -2 out of 7, P.faciparum – 1 out of 12 . Both the tests became negative in 6 patients (1 P.falciparum & 5 P.vivax)whocamefor follow up in aweek period.

Conclusion

P.vivax also should be considered in patients with severe thrombocytopenia and acute renal failure. Employing rapid Ag detection ICT in endemic areas will reduce the indiscriminate use of anti malarial drugs and drug resistant malaria. It should be confirmed by microscopy. A more sensitivemethod holds justice , when microscopy and expertise are not available.

Keywords: acute renal failure , thrombocytopenia, P.vivax , epidemic, endemic, microscopy, Ag detection ICT