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Sunday 27th May 2018

Study finds flaws in malaria care

28th February 2007

Malaria is being overdiagnosed in Tanzania, and therefore possibly in many other sub-Saharan African countries, leading to overuse of drugs which then don't reach the children who need them.


A study published in the British Medical Journal said rapid diagnostic tests had considerable potential as a tool to improve the diagnosis of malaria.

"Several commercially available tests are sensitive, specific, and stable under operational conditions. Although microscopy remains the gold standard for diagnosis of malaria, its accuracy under operational conditions in Africa is often low, and clinicians are aware of this," said the study, which was led by Hugh Reyburn of the London School of Hygiene and Tropical Medicine.

Malaria is the most common single diagnosis made in most countries in Africa, but it is very hard to tell from symptoms alone whether the patient's fever is caused by the mosquito-borne parasite, or by some other, bacterial, infection.

"Presumptive antimalarial treatment for any fever with no obvious alternative cause is widely practised, and studies suggest that this leads to significant overuse of antimalarial drugs throughout Africa," researchers found.

"This over-diagnosis of malaria in the formal healthcare sector coexists with under-diagnosis of malaria in the community, with the result that antimalarials are given to people who do not need them and not given to children who do."

Overdiagnosis also threatened the sustainability of deployment of artemisinin combination treatment, and treatable bacterial diseases were likely to be missed as a result, the study said.

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