Accuracy of Clinical Diagnosis of Malaria in Children under Five in Lagos

Abstract

Background: Malaria diagnosis is confirmed by finding asexual parasites in peripheral blood firm. Due to the absence of microscopy at most health centers, clinical judgment is often used to make the diagnosis. Studies on clinical accuracy have been done but none from Lagos .
Objective: To document the accuracy of clinical diagnosis of malaria among children under five years .
Methods:
A prospective study on children under five years presenting with fever presenting to the children\'s Emergency Room, LUTH. The study was done between January and October 2001.
Result: A total of 184/323 children had a clinical diagnosis of malaria. The diagnosis was confirmed in 57 (31%) of them . Those with a clinical diagnosis of severe malaria had a higher chance of it actually being malaria compared with those with a clinical diagnosis of acute malaria (p<0.000001). Clinical diagnosis had a sensitivity of 68% and a specificity of 41%. Its positive predictive value was 31%.
Conclusion: The accuracy of clinical diagnosis was poor in children. We recommend the strengthening of basic health services.


NQJHM Vol. 14 (1) 2004: pp. 101-103