Malaria misdiagnosis: effects on the poor and vulnerable.
BACKGROUND
Effective and affordable treatment is recommended for all cases of malaria within 24 h of the onset of illness. Most cases of "malaria" (ie, fever) are self-diagnosed and most treatments, and deaths, occur at home. The most ethical and cost-effective policy is to ensure that newer drug combinations are only used for true cases of malaria. Although it is cost effective to improve the accuracy of malaria diagnosis, simple, accurate, and inexpensive methods are not widely available, particularly in poor communities where they are most needed.


BACKGROUND
In a recent study in Uganda, Karin Kallander and colleagues emphasise the difficulty in making a presumptive diagnosis of malaria, and highlight the urgent need for improved diagnostic tools that can be used at community and primary-care level, especially in poorer populations (Acta Trop 2004; 90: 211-14). WHERE NEXT? Health systems need strengthening at referral and community level, so that rapid accurate diagnosis and effective treatment is available for those who are least able to withstand the consequences of illness. Indirect evidence strongly suggests that misdiagnosis of malaria contributes to a vicious cycle of increasing ill-health and deepening poverty. Much better direct evidence is needed about why and how misdiagnosis affects the poor and vulnerable.
Amexo
Mark
M
Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK.
Tolhurst
Rachel
R
Barnish
Guy
G
Bates
Imelda
I
D000962:Antimalarials / Q000191:economics / Q000627:therapeutic use; D003906:Developing Countries; D003951:Diagnostic Errors; D016527:Drug Costs; D006801:Humans; D008288:Malaria / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D011203:Poverty
D000962:Antimalarials