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“Background: Prompt, accurate diagnosis and treatment with artemisinin combination therapy remains vital to current malaria control. Blood film microscopy the current standard test for diagnosis of malaria has several limitations that necessitate
field evaluation of alternative diagnostic methods especially in low income countries of sub-Saharan Africa where malaria is endemic.
Methods: The accuracy of axillary temperature, health Nec-1s ic50 centre (HC) microscopy, expert microscopy and a HRP2-based rapid diagnostic test (Paracheck) was compared in predicting malaria infection using polymerase chain reaction (PCR) as the gold standard. Three hundred patients with a clinical suspicion of malaria based on fever and or history of fever from a low and high transmission setting in Uganda were consecutively enrolled and provided blood
samples for all tests. Accuracy of each test was calculated overall with 95% confidence interval and then adjusted for age-groups and level of transmission intensity using LOXO-101 a stratified analysis. The endpoints were: sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). This study is registered with Clinicaltrials.gov, NCT00565071.
Results: Of the 300 patients, 88(29.3%) had fever, 56(18.7%) were positive by HC microscopy, 47(15.7%) by expert microscopy, 110(36.7%) by Paracheck and 89(29.7%) by PCR. The overall sensitivity >90% was only shown by Paracheck 91.0% [95% CI: 83.1-96.0]. The sensitivity of expert microscopy was 46%, similar to HC microscopy. The superior sensitivity of Paracheck compared to microscopy was maintained when data was stratified for transmission intensity and age. The overall specificity rates were: Paracheck 86.3% [95% CI:
80.9-90.6], HSP990 cost HC microscopy 93.4% [95% CI: 89.1-96.3] and expert microscopy 97.2% [95% CI: 93.9-98.9]. The NPV >90% was shown by Paracheck 95.8% [95% CI: 91.9-98.2]. The overall PPV was <88% for all methods.
Conclusion: The HRP2-based RDT has shown superior sensitivity compared to microscopy in diagnosis of malaria and may be more suitable for screening of malaria infection.”
“This study represents the behavior of flexural test of methyl methacrylate modified unsaturated polyester polymer concrete beam reinforced with glass-fiber-reinforced polymer (GFRP) sheets. The failure mode, load-deflection, ductility index, and separation load predictions according to the GFRP reinforcement thickness were tested and analyzed. The failure mode was found to occur at the bonded surface of the specimen with 10 layers of GFRP reinforcement. For the load-deflection curve, as the reinforcement thickness of the GFRP sheet increased, the crack load and ultimate load greatly increased, and the ductility index was found to be the highest for the beam with the thickness of the GFRP sheet at 10 layers (6 mm) or 13 layers (7.3 mm).