Rationalization of the Laboratory Diagnosis for Good Management of Malaria: Lessons from Transitional Methods.

Introduction: Malaria is an endemic disease in sub-Saharan Africa. In clinical practice, the main concern is the overdiagnosis of malaria leading to inappropriate drug prescription without laboratory confirmation. Objective: This study aimed to evaluate clinical examination reliability compared with translational laboratory methods of malaria diagnosis. Methods: The study was conducted in Goundi Hospital among hospitalized patients over a seven-month period. Patients were interviewed, and malaria tests done included the Giemsa-stained thick and thin blood smears. Diagnostic accuracy was analysed by calculating sensitivity, specificity, and predictive values. Results: Among 1,874 participants, 674 (35.96%) patients had positive Giemsa-stained thick blood films. The rate of positivity is higher for patients under 5 years of age. The parasite densities were between 160 and 84.000 parasites/ Conclusion: A presumptive diagnosis of malaria should be confirmed by the laboratory in all suspected cases in all possible scenarios. Every parasitemia should be followed by the calculation of parasitic density. However, for the children under 5 years of age in areas of high transmission, the presumptive diagnosis of malaria in certain circumstances could be considered.