University of Surrey

Test tubes in the lab Research in the ATI Dance Research

Investigating portable fluorescent microscopy (CyScope) as an alternative rapid diagnostic test for malaria in children and women of child-bearing age.

Sousa-Figueiredo, JC, Oguttu, D, Adriko, M, Besigye, F, Nankasi, A, Arinaitwe, M, Namukuta, A, Betson, M, Kabatereine, NB and Stothard, JR (2010) Investigating portable fluorescent microscopy (CyScope) as an alternative rapid diagnostic test for malaria in children and women of child-bearing age. Malar J, 9.

[img]
Preview
Text
Investigating portable fluorescent microscopy (CyScope) as an alternative rapid diagnostic test for malaria in children and women of child-bearing age..pdf - ["content_typename_Published version (Publisher's proof or final PDF)" not defined]
Available under License : See the attached licence file.

Download (322kB) | Preview
[img]
Preview
PDF (licence)
SRI_deposit_agreement.pdf
Available under License : See the attached licence file.

Download (33kB) | Preview

Abstract

BACKGROUND: Prompt and correct diagnosis of malaria is crucial for accurate epidemiological assessment and better case management, and while the gold standard of light microscopy is often available, it requires both expertise and time. Portable fluorescent microscopy using the CyScope offers a potentially quicker, easier and more field-applicable alternative. This article reports on the strengths, limitations of this methodology and its diagnostic performance in cross-sectional surveys on young children and women of child-bearing age. METHODS: 552 adults (99% women of child-bearing age) and 980 children (99% ≤ 5 years of age) from rural and peri-urban regions of Ugandan were examined for malaria using light microscopy (Giemsa-stain), a lateral-flow test (Paracheck-Pf) and the CyScope. Results from the surveys were used to calculate diagnostic performance (sensitivity and specificity) as well as to perform a receiver operating characteristics (ROC) analyses, using light microscopy as the gold-standard. RESULTS: Fluorescent microscopy (qualitative reads) showed reduced specificity (<40%), resulting in higher community prevalence levels than those reported by light microscopy, particularly in adults (+180% in adults and +20% in children). Diagnostic sensitivity was 92.1% in adults and 86.7% in children, with an area under the ROC curve of 0.63. Importantly, optimum performance was achieved for higher parasitaemia (>400 parasites/μL blood): sensitivity of 64.2% and specificity of 86.0%. Overall, the diagnostic performance of the CyScope was found inferior to that of Paracheck-Pf. DISCUSSION: Fluorescent microscopy using the CyScope is certainly a field-applicable and relatively affordable solution for malaria diagnoses especially in areas where electrical supplies may be lacking. While it is unlikely to miss higher parasitaemia, its application in cross-sectional community-based studies leads to many false positives (i.e. small fluorescent bodies of presently unknown origin mistaken as malaria parasites). Without recourse to other technologies, arbitration of these false positives is presently equivocal, which could ultimately lead to over-treatment; something that should be further explored in future investigations if the CyScope is to be more widely implemented.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences
Authors :
AuthorsEmailORCID
Sousa-Figueiredo, JCUNSPECIFIEDUNSPECIFIED
Oguttu, DUNSPECIFIEDUNSPECIFIED
Adriko, MUNSPECIFIEDUNSPECIFIED
Besigye, FUNSPECIFIEDUNSPECIFIED
Nankasi, AUNSPECIFIEDUNSPECIFIED
Arinaitwe, MUNSPECIFIEDUNSPECIFIED
Namukuta, AUNSPECIFIEDUNSPECIFIED
Betson, MUNSPECIFIEDUNSPECIFIED
Kabatereine, NBUNSPECIFIEDUNSPECIFIED
Stothard, JRUNSPECIFIEDUNSPECIFIED
Date : January 2010
Identification Number : 10.1186/1475-2875-9-245
Uncontrolled Keywords : Adolescent, Adult, Child, Preschool, Cross-Sectional Studies, Diagnostic Tests, Routine, Female, Humans, Infant, Malaria, Male, Microscopy, Fluorescence, Middle Aged, Parasitology, Predictive Value of Tests, ROC Curve, Rural Population, Time Factors, Uganda, Young Adult
Related URLs :
Additional Information : © 2010 Sousa-Figueiredo et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Depositing User : Symplectic Elements
Date Deposited : 14 Aug 2015 09:52
Last Modified : 14 Aug 2015 09:52
URI: http://epubs.surrey.ac.uk/id/eprint/808121

Actions (login required)

View Item View Item

Downloads

Downloads per month over past year


Information about this web site

© The University of Surrey, Guildford, Surrey, GU2 7XH, United Kingdom.
+44 (0)1483 300800