Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jan 6;6(1):e252.
doi: 10.1371/journal.pmed.0050252.

Time to move from presumptive malaria treatment to laboratory-confirmed diagnosis and treatment in African children with fever

Valérie D'Acremont  1 , Christian Lengeler, Hassan Mshinda, Deo Mtasiwa, Marcel Tanner, Blaise Genton
Affiliations

Time to move from presumptive malaria treatment to laboratory-confirmed diagnosis and treatment in African children with fever

Valérie D'Acremont et al. PLoS Med. .

Abstract

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.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Comment in

References

    1. World Health Organization. Impact of long-lasting insecticidal-treated nets (LLINs) and artemisinin-based combination therapies (ACTs) measured using surveillance data, in four African countries. 2008. Available: http://www.who.int/malaria/docs/ReportGFImpactMalaria.pdf. Accessed 17 November 2008.
    1. Guerra CA, Gikandi PW, Tatem AJ, Noor AM, Smith DL, et al. The limits and intensity of Plasmodium falciparum transmission: Implications for malaria control and elimination worldwide. PLoS Med. 2008;5:e38. doi: 10.1371/journal.pmed.0050038. - DOI - PMC - PubMed
    1. Wang SJ, Lengeler C, Mtasiwa D, Mshana T, Manane L, et al. Rapid Urban Malaria Appraisal (RUMA) II: Epidemiology of urban malaria in Dar es Salaam (Tanzania) Malar J. 2006;4:28. - PMC - PubMed
    1. Reyburn H, Mbatia R, Drakeley C, Carneiro I, Mwakasungula E, et al. Overdiagnosis of malaria in patients with severe febrile illness in Tanzania: A prospective study. BMJ. 2004;329:1212. - PMC - PubMed
    1. Marx A, Pewsner D, Egger M, Nuesch R, Bucher HC, et al. Meta-analysis: Accuracy of rapid tests for malaria in travelers returning from endemic areas. Ann Intern Med. 2005;142:836–846. - PubMed