BMJ  2007;334:489 (10 March), doi:10.1136/bmj.39143.024838.1F

Letters

Malaria

Stop ambiguous messages on malaria diagnosis

The first 150 words of the full text of this article appear below.

Reyburn et al's findings on malaria case management in endemic areas are worrying.¹ Part of the problem is due to ambiguous messages provided by malaria experts and national guidelines on how to take action on the result of a malaria test. Undoubtedly, the ambiguity of national malaria control programme guidelines on the management of suspected malaria in children younger than 5 years is a factor.²

In Tanzania the recommendation is to perform microscopy/rapid diagnostic tests for malaria. If results are negative and there are no signs and symptoms of severe disease in a child under 5 years, treat as uncomplicated malaria and look for another condition.³ Similar inconsistency is found in the Ugandan guidelines.

The risk of missing a true malaria case in the event of a negative test and the resulting consequences have recently been evaluated thoroughly in Uganda.⁴ Febrile children were not given antimalarials when the results of . . . [Full text of this article]

Ifakara Health Research and Development Centre, Box 78373, Dar es Salaam, Tanzania, and Swiss Tropical Institute, 4002 Basel, Switzerland

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Relevant Article

Rapid diagnostic tests compared with malaria microscopy for guiding outpatient treatment of febrile illness in Tanzania: randomised trial

Hugh Reyburn, Hilda Mbakilwa, Rose Mwangi, Ombeni Mwerinde, Raimos Olomi, Chris Drakeley, and Christopher J M Whitty
BMJ 2007 334: 403. [Abstract] [Full Text] [PDF]