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. 2010 Apr 21:9:104.
doi: 10.1186/1475-2875-9-104.

Can treatment of malaria be restricted to parasitologically confirmed malaria? A school-based study in Benin in children with and without fever

Jean-François Faucher  1 , Patrick Makoutode, Grace Abiou, Todoégnon Béhéton, Pascal Houzé, Edgard Ouendo, Sandrine Houzé, Philippe Deloron, Michel Cot
Affiliations

Can treatment of malaria be restricted to parasitologically confirmed malaria? A school-based study in Benin in children with and without fever

Jean-François Faucher et al. Malar J. .

Abstract

Background: Applying the switch from presumptive treatment of malaria to new policies of anti-malarial prescriptions restricted to parasitologically-confirmed cases is a still unsolved challenge. Pragmatic studies can provide data on consequences of such a switch. In order to assess whether restricting anti-malarials to rapid diagnostic test (RDT)-confirmed cases in children of between five and 15 years of age is consistent with an adequate management of fevers, a school-based study was performed in Allada, Benin.

Methods: Children in the index group (with fever and a negative RDT) and the matched control group (without fever and a negative RDT) were not prescribed anti-malarials and actively followed-up during 14 days. Blood smears were collected at each assessment. Self-medication with chloroquine and quinine was assessed with blood spots. Malaria attacks during the follow-up were defined by persistent or recurrent fever concomitant to a positive malaria test.

Results: 484 children were followed-up (242 in each group). At day 3, fever had disappeared in 94% of children from the index group. The incidence of malaria was similar (five cases in the index group and seven cases in the control group) between groups. Self-medication with chloroquine and quinine in this cohort was uncommon.

Conclusions: Applying a policy of restricting anti-malarials to RDT-confirmed cases is consistent with an adequate management of fevers in this population. Further studies on the management of fever in younger children are of upmost importance.

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Figures

Figure 1
Figure 1
Profile of visits made to the study clinic.
See this image and copyright information in PMC

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