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Performance of point-of-care diagnostics for glucose, lactate, and hemoglobin in the management of severe malaria in a resource-constrained hospital in Uganda.
Title | Performance of point-of-care diagnostics for glucose, lactate, and hemoglobin in the management of severe malaria in a resource-constrained hospital in Uganda. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Hawkes, M, Conroy, AL, Opoka, RO, Namasopo, S, Liles, CW, John, CC, Kain, KC |
Journal | Am J Trop Med Hyg |
Volume | 90 |
Issue | 4 |
Pagination | 605-8 |
Date Published | 2014 Apr |
ISSN | 1476-1645 |
Keywords | Anemia, Blood Glucose, Child, Child, Preschool, Cohort Studies, Female, Health Resources, Hemoglobin A, Hospitals, Humans, Hypoglycemia, Infant, Lactic Acid, Malaria, Male, Point-of-Care Systems, Sensitivity and Specificity, Uganda |
Abstract | Severe malaria is frequently managed without access to laboratory testing. We report on the performance of point-of-care tests used to guide the management of a cohort of 179 children with severe malaria in a resource-limited Ugandan hospital. Correlation coefficients between paired measurements for glucose (i-STAT and One Touch Ultra), lactate (i-STAT and Lactate Scout), and hemoglobin (Hb; laboratory and i-STAT) were 0.86, 0.85, and 0.73, respectively. The OneTouch Ultra glucometer readings deviated systematically from the i-STAT values by +1.7 mmol/L. Lactate Scout values were systematically higher than i-STAT by +0.86 mmol/L. Lactate measurements from either device predicted subsequent mortality. Hb estimation by the i-STAT instrument was unbiased, with upper and lower limits of agreement of -34 and +34 g/L, and it was 91% sensitive and 89% specific for the diagnosis of severe anemia (Hb < 50 g/L). New commercially available bedside diagnostic tools, although imperfect, may expedite clinical decision-making in the management of critically ill children in resource-constrained settings. |
DOI | 10.4269/ajtmh.13-0689 |
Alternate Journal | Am. J. Trop. Med. Hyg. |
PubMed ID | 24591431 |