Time to move from presumptive malaria treatment to laboratory-confirmed diagnosis and treatment in African children with fever.
Current guidelines recommend that all fever episodes in African children be treated presumptively with antimalarial drugs. But declining malarial transmission in parts of sub-Saharan Africa, declining proportions of fevers due to malaria, and the availability of rapid diagnostic tests mean it may be time for this policy to change. This debate examines whether enough evidence exists to support abandoning presumptive treatment and whether African health systems have the capacity to support a shift toward laboratory-confirmed rather than presumptive diagnosis and treatment of malaria in children under five.
D'Acremont
Valérie
V
Swiss Tropical Institute, Basel, Switzerland.
Lengeler
Christian
C
Mshinda
Hassan
H
Mtasiwa
Deo
D
Tanner
Marcel
M
Genton
Blaise
B
D017954:Africa South of the Sahara; D000962:Antimalarials / Q000627:therapeutic use*; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000706:statistics & numerical data*; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008288:Malaria / Q000150:complications / Q000175:diagnosis* / Q000635:transmission
D000962:Antimalarials