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Rapid diagnostic tests for malaria

BMJ 2014; 348 doi: (Published 19 June 2014) Cite this as: BMJ 2014;348:g3846
  1. Zeno Bisoffi, director1,
  2. Federico Gobbi, physician1,
  3. Jef Van den Ende, professor2
  1. 1Ospedale Sacro Cuore, Centro per le Malattie Tropicali, Verona, Italy
  2. 2Institute of Tropical Medicine, Antwerp, Belgium
  1. Correspondence to: Z Bisoffi zeno.bisoffi{at}

A useful tool for managing fever in countries with endemic disease, but not necessarily a substitute for good microscopy

Despite a decline in incidence, malaria remains one of the leading infectious causes of mortality worldwide.1 Although Asia accounts for the largest proportion of the world’s population exposed to malaria,1 most clinical cases and deaths from the disease occur in sub-Saharan Africa. This is due to a higher, average intensity of malaria transmission in sub-Saharan Africa and to the infective species involved. Plasmodium falciparum, the parasite responsible for the most severe form of malaria and the majority of deaths from the disease, largely occurs in Africa, whereas Plasmodium vivax, the parasite that generally causes a more benign disease, is the predominant species in most of Asia.

The management of malaria, especially in Africa, has long relied on clinical, presumptive management, as most patients are seen at remote dispensaries with no laboratory facility. In early 2000 the widespread introduction of the rapid diagnostic test (RDT) for malaria, a test that is easy to use and requires no equipment, led to the current recommendation of testing all suspected cases and treating only those …

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