In the accompanying study, Lubell and colleagues assess the effect of clinicians’ adherence to the results of a rapid diagnostic test or microscopy on the overall costs of the management of malaria in Tanzania.1

In recent years, most treatment policies for malaria in Africa have shifted to artemisinin combination treatments, which are highly effective but more expensive than older regimens. To avoid over prescription, current guidelines recommend that the diagnosis should be confirmed with a laboratory test before treatment. Immunochromatographic tests for malaria allow diagnosis to be made even in health settings that lack laboratory facilities. Economic models and decision making models support the use of these tests.234 However, models generally assume that clinicians or nurse practitioners fully adhere to the test result when deciding how to manage the patient. But evidence proves the opposite—clinicians are likely to treat people for malaria even after negative results from rapid diagnostic tests or …