Malaria screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2], Marjan Khan M.B.B.S.[3]

Overview

Screening of malaria is important in Sub-Saharan refugees and blood donors.[1]

Screening

Screening for malaria infection is important in:[1]

  • Sub-Saharan refugees
    • A sub-optimal alternative to presumptive therapy is to test newly arriving for malaria infection.
    • Studies have demonstrated that a single malaria thick-and-thin blood smear lacks sensitivity for detecting asymptomatic or sub-clinical malaria in these populations.
    • Three separate blood films taken at 12 to 24 hour intervals, the standard recommendation for diagnosis of clinical malaria, has a greater sensitivity. However, this approach is rarely feasible for screening newly arriving refugee populations because of cost constraints and the need for multiple visits.
    • When a refugee does not receive presumptive therapy they should be monitored for signs or symptoms of disease, particularly during the initial 3 months after arrival, regardless of the post-arrival testing results.

WHO Guidlines

  • In 1968, the World Health Organization published guidelines for the establishment of a screening program that can be summarized in 10 principles:
  1. The disease should be an important health problem.
  2. The natural history of the disease should be understood adequately.
  3. A latent stage of the disease occurs.
  4. A test for the disease is available.
  5. The test is acceptable to the population.
  6. Treatment for the disease exist.
  7. facilities for diagnosis and treatment are available.
  8. A policy about who to treat has been agreed on.
  9. Case finding costs should be considered in relation to medical expenditure as a whole.
  10. Case finding should be organized as an ongoing process rather than a one-time only project.
  • These guidelines form the theoretic basis of most screening programs including malaria that are currently in use.

References

  1. 1.0 1.1 "Immigrant and Refugee Health".
  2. Lee SH, Kara UA, Koay E, Lee MA, Lam S, Teo D (2002). "New strategies for the diagnosis and screening of malaria". Int J Hematol. 76 Suppl 1: 291–3. PMID 12430867.



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