الفهرس 
Historical review of malariaOnly 14 pages are availabe for public view
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Abstract
Background: Malaria morbidity and mortality can be prevented or minimized by rapid diagnosis and treatment. bRDT for malaria are currently in use but other body fluids specific diagnostic test kits are being developed. One of these tests is UMT dipstick, it is a one-step test used to detect HRP2, a polyhistidine antigen of Pf in urine of affected patients.
Aim: The aim of the present study was to evaluate the role of UMT in diagnosis of Pf malaria and its ability to detect the limits of Pf parasitemia in febrile patients admitted in Abbassia Fever Hospital, Egypt.
Patient and methods: This study was conducted on 52 Pf malarial patients who were admitted in Abbassia Fever Hospital. Patients were subjected to meticulous history taking, clinical examination, routine laboratory investigations, abdominal ultrasound, blood film microscopy for malaria, RBT and UMT. Confirmed Pf malaria in the studied patients was based on the presence of positive parasite-based tests (+ve blood film microscopy with/without RBT for Pf malaria).
Results: Statistical analysis of the presenting data revealed that;
about 90% of studied malarial patients aged >17 years and non-was less than 5 years age. Male (78.85%): Female (21.15%) ratio in studied malarial patients was 3.73: 1. In order of frequency, source of malaria infection in studied patients were North and South Sudan (50% of cases), Nigeria (25% of cases), Chad (7.69% of cases) and Genia (5.77% of cases), regarding occupation, about half of cases were non-worker (53.85%) and about 14 (26.92%) were students.
fever was a constant finding in all cases followed by vomiting (50%), abdominal pain (46.15%), acidotic like breathing (42.31%), pallor (25%) and various degrees of disturbed conscious level (21.15%). Other apparent less frequent features were Hepatomegaly &/or splenomegaly (17.3%), jaundice (11.54%), prostration and oliguria or anuria (5.77% for each) and pulmonary edema, convulsions and cyanosis (3.84% for each).
ABG was done to 22 patients with acidotic like breathing [6 patients with mild to severe disturbed conscious level (GCS < 12), 5 patients below 17 years old, 4 patients with clinically apparent jaundice with serum bilirubin >3 mg/dL, 3 patients with renal failure, 3 patients with classical acidotic breathing and 1 pregnant female. ABG proved the presence of definite metabolic acidosis (bicarb <15 mmol/L)] in three of these patients. None of the studied malarial patients presented with hypoglycemia nor developed hypoglycemia neither on admission nor on follow up.
blood film microscopy and RBT for Pf malaria were +ve in all studied patients (100%), while UMT was +ve in half of studied cases (50%) with false -ve results in 50% of parasitologically confirmed Pf cases. Parasitological malarial index revealed the presence of hyperparasitemia (index>4%) in 3 patients.
thirty-six out of 52 patients (69.23%) had uncomplicated malaria and 10 out of 52 patients (19.23%) had severe malaria [GCS<11 (11.54%) (2 of them had cerebral malaria), S. bilirubin>3 mg/dL (11.54%), prostration (5.77%), metabolic acidosis [arterial blood HCO3-<15 mmol/L (5.77%)], renal failure (5.77%), pulmonary edema (3.85%), multiple convulsions (3.85%)]. In addition, one pregnant female and 5 children aged ≤17 years managed as severe malaria according WHO definition of severe malaria.
fifty-one patients (98.08 %) recovered completely without sequalae while only 1 patient died from renal failure.
there was significant difference between positive UMT and each of the following: lower GCS scores (p 0.022), lower mean PLT count (p 0.015), higher parasitemia (p 0.016) and severity of malaria (p 0.002). There was no significant relation between UMT results with age and sex.
the sensitivity, Specificity, PPV, NPV and accuracy of +ve UMT in diagnosis of P.f malaria at parasitological index ≤0.5% were 43.75, 47.22, 26.92, 65.38, 46.15 respectively, while at detected lower most parasitological index (0.1% index = 5000 parasites/μL) the sensitivity of the test was 28.57%.