@article{fdi:010049613,
  title = {{U}se of {HRP}-2-based rapid diagnostic test for {P}lasmodium falciparum malaria : assessing accuracy and cost-effectiveness in the villages of {D}ielmo and {N}diop, {S}enegal},
  author = {{L}y, {A}. {B}. and {T}all, {A}. and {P}erry, {R}. and {B}aril, {L}. and {B}adiane, {A}. and {F}aye, {J}. and {R}ogier, {C}. and {T}oure, {A}. and {S}okhna, {C}heikh and {T}rape, {J}ean-{F}rancois and {M}ichel, {R}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {I}n 2006, the {S}enegalese {N}ational {M}alaria {C}ontrol {P}rogramme ({NMCP}) has recommended artemisinin-based combination therapy ({ACT}) as the first-line treatment for uncomplicated malaria and, in 2007, mandated testing for all suspected cases of malaria with a {P}lasmodium falciparum {HRP}-2-based rapid diagnostic test for malaria ({RDT}({P}aracheck ({R})). {G}iven the higher cost of {ACT} compared to earlier anti-malarials, the objectives of the present study were i) to study the accuracy of {P}aracheck ({R}) compared to the thick blood smear ({TBS}) in two areas with different levels of malaria endemicity and ii) analyse the cost-effectiveness of the strategy of the parasitological confirmation of clinically suspected malaria cases management recommended by the {NMCP}. {M}ethods: {A} cross-sectional study was undertaken in the villages of {D}ielmo and {N}diop ({S}enegal) nested in a cohort study of about 800 inhabitants. {F}or all the individuals consulting between {O}ctober 2008 and {J}anuary 2009 with a clinical diagnosis of malaria, a questionnaire was filled and finger-prick blood samples were taken both for microscopic examination and {RDT}. {T}he estimated costs and cost-effectiveness analysis were made considering five scenarios, the recommendations of the {NMCP} being the reference scenario. {I}n addition, a sensitivity analysis was performed assuming that all the {RDT}-positive patients and 50% of {RDT}-negative patients were treated with {ACT}. {R}esults: {A} total of 189 consultations for clinically suspected malaria occurred during the study period. {T}he sensitivity, specificity, positive and negative predictive values were respectively 100%, 98.3%, 80.0% and 100%. {T}he estimated cost of the reference scenario was close to 700(sic) per 1000 episodes of illness, approximately twice as expensive as most of the other scenarios. {N}evertheless, it appeared to us cost-effective while ensuring the diagnosis and the treatment of 100% of malaria attacks and an adequate management of 98.4% of episodes of illness. {T}he present study also demonstrated that full compliance of health care providers with {RDT} results was required in order to avoid severe incremental costs. {C}onclusions: {A} rational use of {ACT} requires laboratory testing of all patients presenting with presumed malaria. {U}se of {RDT}s inevitably has incremental costs, but the strategy associating {RDT} use for all clinically suspected malaria and prescribing {ACT} only to patients tested positive is cost-effective in areas where microscopy is unavailable.},
  keywords = {},
  booktitle = {},
  journal = {{M}alaria {J}ournal},
  volume = {9},
  numero = {},
  pages = {153},
  ISSN = {1475-2875},
  year = {2010},
  DOI = {10.1186/1475-2875-9-153},
  URL = {https://www.documentation.ird.fr/hor/fdi:010049613},
}