Working without a blindfold: the critical role of diagnostics in malaria control

<p>Abstract</p> <p>Diagnostic testing for malaria has for many years been eschewed, lest it be an obstacle to the delivery of rapid, life-saving treatment. The approach of treating malaria without confirmatory testing has been reinforced by the availability of inexpensive treatment...

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Main Authors: Bell David R, Perkins Mark D
Format: Article
Language:English
Published: BMC 2008-12-01
Series:Malaria Journal
Online Access:http://www.malariajournal.com/content/7/S1/S5
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author Bell David R
Perkins Mark D
author_facet Bell David R
Perkins Mark D
author_sort Bell David R
collection DOAJ
description <p>Abstract</p> <p>Diagnostic testing for malaria has for many years been eschewed, lest it be an obstacle to the delivery of rapid, life-saving treatment. The approach of treating malaria without confirmatory testing has been reinforced by the availability of inexpensive treatment with few side effects, by the great difficulty of establishing quality-assured microscopy in rural and resource-poor settings, and by the preeminence of malaria as a cause of important fever in endemic regions. Within the last decade, all three of these factors have changed. More expensive artemisinin combination therapy (ACT) has been widely introduced, simple immunochromatographic tests for malaria have been developed that can be used as an alternative to microscopy by village health workers, and recognition of the health cost of mismanaging non-malarial fever is growing. In most of the world a small fraction of fever is due to malaria, and reflex treatment with ACT does not make medical or economic sense. Global malaria control efforts have been energized by the availability of new sources of funding, and by the rapid reduction in malaria prevalence in a number of settings where bed nets, indoor residual spraying with insecticides, and ACT have been systematically deployed. This momentum has been captured by a new call for malaria elimination. Without wide implementation of accurate and discriminating diagnostic testing, and reporting of results, most fever will be inappropriately managed, millions of doses of ACT will be wasted, and malaria control programmes will be blindfolded to the impact of their efforts.</p>
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spelling doaj.art-268490fdbf5c469fa4807e773a4573b72022-12-21T23:26:54ZengBMCMalaria Journal1475-28752008-12-017Suppl 1S510.1186/1475-2875-7-S1-S5Working without a blindfold: the critical role of diagnostics in malaria controlBell David RPerkins Mark D<p>Abstract</p> <p>Diagnostic testing for malaria has for many years been eschewed, lest it be an obstacle to the delivery of rapid, life-saving treatment. The approach of treating malaria without confirmatory testing has been reinforced by the availability of inexpensive treatment with few side effects, by the great difficulty of establishing quality-assured microscopy in rural and resource-poor settings, and by the preeminence of malaria as a cause of important fever in endemic regions. Within the last decade, all three of these factors have changed. More expensive artemisinin combination therapy (ACT) has been widely introduced, simple immunochromatographic tests for malaria have been developed that can be used as an alternative to microscopy by village health workers, and recognition of the health cost of mismanaging non-malarial fever is growing. In most of the world a small fraction of fever is due to malaria, and reflex treatment with ACT does not make medical or economic sense. Global malaria control efforts have been energized by the availability of new sources of funding, and by the rapid reduction in malaria prevalence in a number of settings where bed nets, indoor residual spraying with insecticides, and ACT have been systematically deployed. This momentum has been captured by a new call for malaria elimination. Without wide implementation of accurate and discriminating diagnostic testing, and reporting of results, most fever will be inappropriately managed, millions of doses of ACT will be wasted, and malaria control programmes will be blindfolded to the impact of their efforts.</p>http://www.malariajournal.com/content/7/S1/S5
spellingShingle Bell David R
Perkins Mark D
Working without a blindfold: the critical role of diagnostics in malaria control
Malaria Journal
title Working without a blindfold: the critical role of diagnostics in malaria control
title_full Working without a blindfold: the critical role of diagnostics in malaria control
title_fullStr Working without a blindfold: the critical role of diagnostics in malaria control
title_full_unstemmed Working without a blindfold: the critical role of diagnostics in malaria control
title_short Working without a blindfold: the critical role of diagnostics in malaria control
title_sort working without a blindfold the critical role of diagnostics in malaria control
url http://www.malariajournal.com/content/7/S1/S5
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