TRIAL OF THE PARASIGHT-F TEST FOR MALARIA DIAGNOSIS IN THE PRIMARY HEALTH-CARE SYSTEM, ZIMBABWE

Rapid diagnosis of Plasmodium falciparum malaria remains one of the ma in limitations to prompt treatment. Diagnosis based on clinical sympto ms is decidedly unreliable, especially in areas of seasonal transmissi on like Zimbabwe. In view of this, the Plasmodium falciparum histidine -rich protein (HRP-II) antigen detection assay (ParaSight-F test) was tried at Io health centres in 3 malaria endemicity zones of Zimbabwe, as a malaria diagnostic tool for primary health care. Parasitological evaluations were conducted using thick and thin film microscopy as gol d standard, and ease of test operation and practicability to nurses we re ascertained by questionnaire. The sensitivity of the test did not v ary substantially by endemicity zone and was approximate to 93%. Speci ficities were 85, 72 and 92% in the hyperendemic, mesoendemic and hypo endemic zones, respectively. Positive predictive values varied conside rably with endemicity, the lowest being in the hypoendemic zone (56%) However, negative predictive values did not change significantly, with a mean of 94%. It was found that the ParaSight-F test reduced mistrea tment for malaria, relative to clinical diagnosis, by up to 81%, espec ially in the hypoendemic region. Test acceptability evaluations were g ood.