{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:33:59Z","timestamp":1792024439824,"version":"4.4.0"},"reference-count":18,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,4]]},"abstract":"<jats:p>Many countries in Africa, including Sierra Leone, have adopted artemisinin-based combination therapy as first-line therapy for treatment of patients with malaria. Because laboratory testing is often unavailable in rural areas, the cost-benefit and viability of this approach may depend on accurately diagnosing malaria by using clinical criteria. We assessed the accuracy of syndromic diagnosis for malaria in three peripheral health units in rural Sierra Leone and determined factors that were associated with an accurate malaria diagnosis. Of 175 children diagnosed with malaria on syndromic grounds, 143 (82%) were confirmed by the Paracheck-Pf test. In a multivariate analysis, splenomegaly (<jats:italic>P<\/jats:italic> = 0.04) was the only clinical sign significantly associated with laboratory-confirmed malaria, and sleeping under a bed net was protective (<jats:italic>P<\/jats:italic> = 0.05). Our findings show that clinical malaria is diagnosed relatively accurately in rural Sierra Leone. Incorporating bed net use and splenomegaly into the national Integrated Management of Childhood Illness guidelines for evaluation of fever may further enhance diagnostic accuracy for malaria.<\/jats:p>","DOI":"10.4269\/ajtmh.2010.09-0188","type":"journal-article","created":{"date-parts":[[2010,3,26]],"date-time":"2010-03-26T23:33:07Z","timestamp":1269646387000},"page":"525-528","source":"Crossref","is-referenced-by-count":13,"title":["Syndromic Diagnosis of Malaria in Rural Sierra Leone and Proposed Additions to the National Integrated Management of Childhood Illness Guidelines for Fever"],"prefix":"10.4269","volume":"82","author":[{"given":"Obinna N.","family":"Nnedu","sequence":"first","affiliation":[{"name":"Tulane University Health Sciences Center, New Orleans, Louisiana; Medical Research Centre, Bo, Sierra Leone; Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Rimel","sequence":"additional","affiliation":[{"name":"Tulane University Health Sciences Center, New Orleans, Louisiana; Medical Research Centre, Bo, Sierra Leone; Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carey","family":"Terry","sequence":"additional","affiliation":[{"name":"Tulane University Health Sciences Center, New Orleans, Louisiana; Medical Research Centre, Bo, Sierra Leone; Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Jalloh-Vos","sequence":"additional","affiliation":[{"name":"Tulane University Health Sciences Center, New Orleans, Louisiana; Medical Research Centre, Bo, Sierra Leone; Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brima","family":"Baryon","sequence":"additional","affiliation":[{"name":"Tulane University Health Sciences Center, New Orleans, Louisiana; Medical Research Centre, Bo, Sierra Leone; Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel G.","family":"Bausch","sequence":"additional","affiliation":[{"name":"Tulane University Health Sciences Center, New Orleans, Louisiana; Medical Research Centre, Bo, Sierra Leone; Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"N Engl J Med","first-page":"1877","article-title":"Betting on a malaria vaccine","volume":"353","author":"Okie","year":"2005"},{"key":"R2","series-title":"CMAJ","first-page":"161","article-title":"Taking away the sting of malaria","volume":"174","author":"Murray","year":"2006"},{"key":"R3","series-title":"Guidelines for the Treatment of Malaria","author":"World Health Organization","year":"2006"},{"key":"R4","series-title":"N Engl J Med","first-page":"333","article-title":"Making antimalarial agents available in Africa","volume":"353","author":"Arrow","year":"2005"},{"key":"R5","series-title":"World Health Forum","first-page":"200","article-title":"Coordination for better laboratory services","volume":"17","author":"Nageh","year":"1996"},{"key":"R6","series-title":"The Use of Malaria Rapid Diagnostic Tests","author":"World Health Organization","year":"2009"},{"key":"R7","series-title":"Textbook of Critical Care","first-page":"1367","author":"Bausch","year":"2005"},{"key":"R8","series-title":"Handbook. IMCI Integrated Management of Childhood Illness","author":"World Health Organization","year":"2005"},{"key":"R9","series-title":"Trop Med Int Health","first-page":"146","article-title":"Evidence basis for antimalarial policy change in Sierra Leone: five in vivo efficacy studies of chloroquine, sulphadoxine-pyrimethamine and amodiaquine","volume":"10","author":"Checchi","year":"2005"},{"key":"R10","series-title":"Trans R Soc Trop Med Hyg","first-page":"217","article-title":"Cluster of chloroquine-resistant Plasmodium falciparum malaria cases among short-term travellers to Sierra Leone","volume":"84","author":"Lackritz","year":"1990"},{"key":"R11","series-title":"Ann Med Interne (Paris)","first-page":"493","article-title":"Insufficiency of treatment with halofantrine in chloroquinoresistant Plasmodium falciparum malaria in Sierra Leone","volume":"141","author":"Gay","year":"1990"},{"key":"R12","series-title":"Trans R Soc Trop Med Hyg","first-page":"254","article-title":"Validity, reliability and ease of use in the field of five rapid tests for the diagnosis of Plasmodium falciparum malaria in Uganda","volume":"96","author":"Guthmann","year":"2002"},{"key":"R13","series-title":"Trop Doct","first-page":"78","article-title":"Clinical predictors of malaria and other febrile illnesses in children under five on Pemba Island, Tanzania","volume":"35","author":"Yacoub","year":"2005"},{"key":"R14","series-title":"Bull World Health Organ","first-page":"120","article-title":"Effects of insecticide-treated bednets during early infancy in an African area of intense malaria transmission: a randomized controlled trial","volume":"84","author":"Muller","year":"2006"},{"key":"R15","series-title":"BMJ","first-page":"1212","article-title":"Overdiagnosis of malaria in patients with severe febrile illness in Tanzania: a prospective study","volume":"329","author":"Reyburn","year":"2004"},{"key":"R16","series-title":"Ann Trop Med Parasitol","first-page":"445","article-title":"Apparent drug failure following artesunate treatment of Plasmodium falciparum malaria in Freetown, Sierra Leone: four case reports","volume":"95","author":"Sahr","year":"2001"},{"key":"R17","series-title":"Ann Trop Med Parasitol","first-page":"137","article-title":"Malaria in a rural area of Sierra Leone. II. Parasitological and related results from pre- and post-rains clinical surveys","volume":"87","author":"Barnish","year":"1993"},{"key":"R18","series-title":"Public Health","first-page":"149","article-title":"Inland valley swamp rice development: malaria, schistosomiasis, onchocerciasis in south central Sierra Leone","volume":"108","author":"Gbakima","year":"1994"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/82\/4\/article-p525.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/82\/4\/article-p525.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/82\/4\/article-p525.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T15:51:19Z","timestamp":1725292279000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/82\/4\/article-p525.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,4]]},"references-count":18,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.2010.09-0188","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,4]]}}}