Evaluation of Diagnostic Tests in Malaria (Evaluating the Diagnostic Value of Quantitative Buffy Coat and Rapid Diagnostic Test using Plasmodium Lactate Dehydrogenase against the Peripheral Smear Microscopy

INTRODUCTION: Malaria, called as the King of diseases is caused by Plasmodium infection. It’s the most important infectious disease in tropical and sub tropical regions, and continuous to be the major public health problem. Over 40% of the world’s population is exposed to the risk of malaria. According to the World Malaria Report 2010, there were 225 million cases of malaria and an estimated 7, 81,000 deaths in 2009, a decrease from 233 million cases and 9,85,000 deaths in 2000. Most deaths occur among children living in Africa, where a child dies every 45 seconds due to malaria and the disease accounts for approximately 20% of all childhood deaths. Children aged one to four are the most vulnerable group to infection and death. AIM OF THE STUDY: Evaluating the diagnostic value of Quantitative Buffy Coat and Rapid Diagnostic Test (using pLDH ) against the gold standard peripheral smear examination, in the diagnosis of malaria in children between 1month to 12 years of age group. Secondary objective To study the clinical profile of malaria cases detected by peripheral smear. DISCUSSION: In our study,clinical suspicion of malaria was made in 150 children.Among them only 66 were diagnosed to have malaria on the basis of smear positivity. As the symptoms and the signs of malaria are vague, the clinical diagnosis of malaria is very difficult and some times the over enthusiastic diagnosis made on clinical grounds, lead on to unnecessary use of antimalarials, the major cause of emerging drug resistance. So we have to depend on the Laboratory investigations for accurate diagnosis. AGE GROUP: Majority of cases of malaria in our study were between 6 months to 5 years of age group, which coincides with the study of Ahmad et al. GENDER : Female to male ratio is 1.2:1 SEASONAL DISTRIBUTION : The maximum number of cases (38) were observed during July to October with the peak incidence noted in the month of September, which coincides with the monsoon and post monsoon period. This was similar to the earlier observations by Ahmad et al. CONCLUSION: In future the peripheral smear examination can be replaced by Quantitative Buffy Coat technique for the diagnosis of malaria. In resource limited settings where specialized instrumentation facilities are not available, RDT (pLDH) can be used to diagnose malaria