{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:59:14Z","timestamp":1790351954376,"version":"4.1.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T00:00:00Z","timestamp":1611792000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T00:00:00Z","timestamp":1611792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004417","name":"Global Fund to Fight AIDS, Tuberculosis and Malaria","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004417","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Parasitological diagnosis generates data to assist malaria-endemic countries determine their status within the malaria elimination continuum and also inform the deployment of proven interventions to yield maximum impact. This study determined prevalence of malaria parasitaemia and mRDT performances among febrile patients in selected health care facilities across Ghana.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This study was a cross-sectional survey conducted in the previously 10 regions of Ghana from May to August 2018. Each patient suspected to have uncomplicated malaria was tested using microscopy and two malaria rapid diagnostic tests (mRDTs): routinely used CareStart\u2122 Malaria HRP2 (Pf) and SD Bioline Malaria Ag Pf (HRP2\/pLDH). Main outcome variables were malaria slide and CareStart\u2122 Malaria HRP2 (Pf) positivity rates; and diagnostic accuracy of CareStart\u2122 Malaria HRP2 (Pf) and SD Bioline Malaria Ag Pf (HRP2\/pLDH) using microscopy as \u201cgold standard\u201d.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall parasite positivity rates were 32.3% (6266\/19402) by mRDT and 16.0% (2984\/18616) by microscopy, with <jats:italic>Plasmodium falciparum<\/jats:italic> mono-infection accounting for 98.0% of all infections. The odds of parasitaemia by microscopy was significantly lower among female patients compared with males (OR\u2009=\u20090.78; 95% CI: 0.66\u20130.91), and among patients with history of previous antimalarial intake compared with those with no such history (OR\u2009=\u20090.72; 95% CI: 0.54\u20130.95). Overall sensitivity of CareStart\u2122 Malaria HRP2 (Pf) was statistically similar to that of the HRP2 band of SD Bioline Malaria Ag Pf (HRP2\/pLDH) combo kit (95.4%; 95% CI: 94.6\u201396.1 vs 94.3%; 95% CI: 93.4\u201395.1; <jats:italic>p<\/jats:italic>\u2009=\u20090.065) but significantly higher than the pLDH band (89.3%; 95% CI: 88.1\u201390.4; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The same pattern was observed for negative predictive value.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Malaria control interventions should be targeted at the general population, and history of antimalarial intake considered a key predictor of malaria slide negativity. Furthermore, HRP2-based mRDTs remain effective diagnostic tool in the management of suspected uncomplicated malaria in the country.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12889-021-10290-1","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T17:08:15Z","timestamp":1611853695000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Malaria parasitaemia and mRDT diagnostic performances among symptomatic individuals in selected health care facilities across Ghana"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1840-6979","authenticated-orcid":false,"given":"Benjamin","family":"Abuaku","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda Eva","family":"Amoah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nana Yaw","family":"Peprah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Asamoah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunice Obeng","family":"Amoako","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dickson","family":"Donu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George Asumah","family":"Adu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keziah Laurencia","family":"Malm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,28]]},"reference":[{"key":"10290_CR1","volume-title":"World Malaria Report 2019","author":"WHO","year":"2019","unstructured":"WHO. World Malaria Report 2019. Geneva: World Health Organization; 2019."},{"key":"10290_CR2","volume-title":"National Malaria Control Programme 2018 annual report.","author":"Ghana Health Service","year":"2019","unstructured":"Ghana Health Service. National Malaria Control Programme 2018 annual report. Accra: Ghana Health Service; 2019."},{"key":"10290_CR3","volume-title":"Guidelines for the treatment of Malaria","author":"WHO","year":"2015","unstructured":"WHO. Guidelines for the treatment of Malaria. 3rd ed. Geneva: World Health Organization; 2015.","edition":"3"},{"key":"10290_CR4","volume-title":"New perspectives. Malaria diagnosis. Report of a joint WHO\/USAID informal consultation. 25-27 October 1999","author":"WHO","year":"2000","unstructured":"WHO. New perspectives. Malaria diagnosis. Report of a joint WHO\/USAID informal consultation. 25-27 October 1999. Geneva: World Health Organization; 2000. https:\/\/www.who.int\/tdr\/publications\/documents\/malaria-diagnosis.pdf"},{"key":"10290_CR5","volume-title":"A framework for malaria elimination","author":"WHO","year":"2017","unstructured":"WHO. A framework for malaria elimination. Geneva: World Health Organization; 2017. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/254761\/9789241511988-eng.pfd;jsessionid=FE89DD48830EC03C1F69D4EFD81E40?sequence=1"},{"key":"10290_CR6","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s12936-018-2199-3","volume":"17","author":"DF Wirth","year":"2018","unstructured":"Wirth DF, Casamitjana N, Tanner M, Reich MR. Global action for training in malaria elimination. Malar J. 2018;17:51.","journal-title":"Malar J"},{"issue":"10 Suppl 2","key":"10290_CR7","doi-asserted-by":"publisher","first-page":"801","DOI":"10.7196\/SAMJ.7445","volume":"103","author":"D Moonasar","year":"2013","unstructured":"Moonasar D, Morris N, Kleinschmidt I, Maharaj R, Raman J, Mayet NT, et al. What will move malaria control to elimination in South Africa? S Afr Med J. 2013;103(10 Suppl 2):801\u20136. https:\/\/doi.org\/10.7196\/SAMJ.7445.","journal-title":"S Afr Med J"},{"key":"10290_CR8","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s12936-014-0534-x","volume":"14","author":"F Kateera","year":"2015","unstructured":"Kateera F, Mens PF, Hakizimana E, Ingabire CM, Muragijemariya L, Karinda P, et al. Malaria parasite carriage and risk determinants in a rural population: a malariometric survey in Rwanda. Malar J. 2015;14:16.","journal-title":"Malar J"},{"key":"10290_CR9","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1186\/s12936-015-0683-6","volume":"14","author":"AB Adigun","year":"2015","unstructured":"Adigun AB, Gajere EN, Oresanya O, Vounatsou P. Malaria risk in Nigeria: Bayesian geostatistical modelling of 2010 malaria indicator survey data. Mal J. 2015;14:156.","journal-title":"Mal J."},{"key":"10290_CR10","doi-asserted-by":"publisher","first-page":"4","DOI":"10.3390\/tropicalmed2010004","volume":"2","author":"EA Vajda","year":"2017","unstructured":"Vajda EA, Webb CE. Assessing the risk factors associated with malaria in the highlands of Ethiopia: what do we need to know? Trop Med Infect Dis. 2017;2:4.","journal-title":"Trop Med Infect Dis"},{"key":"10290_CR11","unstructured":"Steps in applying Probability Proportional to Size (PPS) and calculating Basic Probability Weights. https:\/\/who.int\/tb\/advisory_bodies\/impact_measurement_taskforce\/meetings\/prevalence_survey\/psws_probability_prop_size_bierrenbach.pdf?ua=1. Accesed 14 December 2017."},{"key":"10290_CR12","volume-title":"Protocol for estimating the prevalence of pfhrp2\/pfhrp3 gene deletions among symptomatic falciparum patients with false-negative RDT results","author":"WHO","year":"2018","unstructured":"WHO. Protocol for estimating the prevalence of pfhrp2\/pfhrp3 gene deletions among symptomatic falciparum patients with false-negative RDT results. Geneva: World Health Organization; 2018."},{"key":"10290_CR13","unstructured":"WHO. Malaria parasite counting. Malaria microscopy standard operating procedure-MM-SOP-09. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/274382\/MM-SOP-09-eng.pdf?sequence=14&isAllowed=y"},{"issue":"3","key":"10290_CR14","doi-asserted-by":"publisher","first-page":"158","DOI":"10.15640\/jehd.v5n3a17","volume":"5","author":"S Adu-Gyamfi","year":"2016","unstructured":"Adu-Gyamfi S, Donkoh WJ, Addo AA. Educational reforms in Ghana: past and present. J Educ Hum Dev. 2016;5(3):158\u201372. https:\/\/doi.org\/10.15640\/jehd.v5n3a17.","journal-title":"J Educ Hum Dev"},{"key":"10290_CR15","unstructured":"Ghana, Act of Parliament of the Republic of Ghana Entitled The Children\u2019s Act, 1998. www.ghanaprisons.gov.gh\/pdf\/Ghana_Childrens_Act-1.pdf. Accessed 31 Dec 2020."},{"key":"10290_CR16","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1007\/s00180-015-0599-1","volume":"31","author":"G Kalema","year":"2016","unstructured":"Kalema G, Molenberghs G, Kassahun W. Second-order generalized estimating equations for correlated count data. Comput Stat. 2016;31:749\u201370. https:\/\/doi.org\/10.1007\/s00180-015-0599-1.","journal-title":"Comput Stat"},{"key":"10290_CR17","doi-asserted-by":"publisher","DOI":"10.1002\/0471249688","volume-title":"Categorical data analysis","author":"A Agresti","year":"2002","unstructured":"Agresti A. Categorical data analysis. 2nd ed. New York: Wiley; 2002.","edition":"2"},{"key":"10290_CR18","volume-title":"Update: Tracking malaria disease prevalence in Ghana","author":"B Abuaku","year":"2019","unstructured":"Abuaku B. Update: Tracking malaria disease prevalence in Ghana. Accra: NMIMR; 2019. 2018 report submitted to the National Malaria Control Programme"},{"key":"10290_CR19","unstructured":"The Gobal Fund. Technical Brief. Malaria, Gender and Human Rights. https:\/\/www.theglobalfund.org\/media\/5536\/core_malariagenderhumanrights_technicalbrief_en.pdf. Accessed 31 December 2020."},{"issue":"1","key":"10290_CR20","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1186\/s13071-018-3130-z","volume":"11","author":"B Abuaku","year":"2018","unstructured":"Abuaku B, Ahorlu C, Psychas P, Ricks P, Oppong S, Mensah S, et al. Impact of indoor residual spraying on malaria parasitaemia in the Bunkpurugu-Yunyoo district in northern Ghana. Parasit Vectors. 2018;11(1):555.","journal-title":"Parasit Vectors"},{"key":"10290_CR21","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.socscimed.2005.11.061","volume":"63","author":"N Dike","year":"2006","unstructured":"Dike N, Onwujekwe O, Ojukwu J, Ikeme A, Uzochukwu B, Shu E. Influence of education and knowledge on perception and practices to control malaria in Southeast Nigeria. Soc Sci Med. 2006;63:103\u20136.","journal-title":"Soc Sci Med"},{"issue":"1","key":"10290_CR22","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1186\/s12889-018-5055-z","volume":"18","author":"FA Diaz-Quijano","year":"2018","unstructured":"Diaz-Quijano FA, Martinez-Vega RA, Rodriguez-Morales AJ, Rojas-Calero RA, Luna-Gonzalez ML, Diaz-Quijano RG. Association between the level of education and knowledge, attitudes and practices regarding dengue in the Caribbean region of Colombia. BMC Public Health. 2018;18(1):143.","journal-title":"BMC Public Health"},{"key":"10290_CR23","doi-asserted-by":"publisher","first-page":"e0203524","DOI":"10.1371\/journal.pone.0203524","volume":"13","author":"D Adu-Gyasi","year":"2015","unstructured":"Adu-Gyasi D, Asante KP, Amoako S, Amoako N, Ankrah L, Dosoo D, et al. Assessing the performance of only HRP2 and HRP2 with pLDH based rapid diagnostic tests for the diagnosis of malaria in middle Ghana, Africa. PLoS One. 2015;13:e0203524.","journal-title":"PLoS One"},{"key":"10290_CR24","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1186\/s12936-018-2613-x","volume":"17","author":"IA Quakyi","year":"2018","unstructured":"Quakyi IA, Adjei GO, Sullivan DJ Jr, Laar A, Stephens JK, Owusu R, et al. Diagnostic capacity, and predictive values of rapid diagnostic tests for accurate diagnosis of Plasmodium falciparum in febrile children in Asante-Akim, Ghana. Mal J. 2018;17:468.","journal-title":"Mal J"},{"issue":"6","key":"10290_CR25","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1097\/JTO.0b013e3181dab122","volume":"5","author":"JN Mandrekar","year":"2010","unstructured":"Mandrekar JN. Simple statistical measures for diagnostic accuracy assessment. J Thorac Oncol. 2010;5(6):763\u20134.","journal-title":"J Thorac Oncol"},{"key":"10290_CR26","unstructured":"Gerstman BB. Epidemiology kept simple. An introduction to traditional and modern epidemiology. 2nd ed. New Jersey: Wiley-Liss; 2003."}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-021-10290-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12889-021-10290-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-021-10290-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T17:09:15Z","timestamp":1611853755000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/s12889-021-10290-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,28]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10290"],"URL":"https:\/\/doi.org\/10.1186\/s12889-021-10290-1","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,28]]},"assertion":[{"value":"22 May 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 January 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study received approval from the Institutional Review Board of the Noguchi Memorial Institute for Medical Research, University of Ghana (study # 068\/17\u201318). Written informed consent was obtained from each adult participant (\u226518\u2009years old) and caregivers of participants less than 18\u2009years old. For participants aged 12-17\u2009years, a written informed assent was obtained in addition to the parental consent. Each consenting or assenting participant was informed of the objectives, methods, anticipated benefits and risks of the study. Participants were informed of the voluntary nature of the study, and their liberty to withdraw without any penalty.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"239"}}