How to treat fevers in African children up for debate

Jan 06, 2009

A new debate in the open access journal PLoS Medicine questions whether all African children with fever should be treated presumptively with antimalarial drugs, or if treatment should wait until laboratory tests confirm malarial infection.

Blaise Genton and colleagues from Tanzania contend that declining malarial transmission rates in parts of sub-Saharan Africa and the availability of rapid diagnostic tests mean that it is time for the policy of presumptive treatment to change. That the proportion of fevers due to malaria has declined substantially, even in highly endemic areas, increases the relative likelihood of missing other potentially fatal diseases in children, argue the authors.

But Mike English and colleagues from Kenya disagree. They argue that there is not yet enough evidence to support abandoning presumptive treatment and that African health systems do not have the capacity to support a shift toward laboratory-confirmed rather than presumptive diagnosis and treatment of malaria in children under five. "If anxiety about drug costs (which are falling) and optimism that malaria is being defeated drive rapid policy change," the authors argue, "this may result in hurried policy doing more harm than good."

Citation: D'Acremont V, Lengeler C, Mshinda H, Mtasiwa D, Tanner M, et al. (2009) Time to move from presumptive malaria treatment to laboratory-confirmed diagnosis and treatment in African children with fever. PLoS Med 6(1): e252. doi:10.1371/journal.pmed.0050252
medicine.plosjournals.org/perl… journal.pmed.0050252

Citation: English M, Reyburn H, Goodman C, Snow RW (2009) Abandoning presumptive antimalarial treatment for febrile children aged less than five years—A case of running before we can walk? PLoS Med 6(1): e1000015. doi:10.1371/journal. pmed.1000015
medicine.plosjournals.org/perl… journal.pmed.1000015

Source: Public Library of Science

Explore further: Demand for cheap food is to blame for widespread chicken contamination

add to favorites email to friend print save as pdf

Related Stories

Rising temperatures can be hard on dogs

40 minutes ago

The "dog days of summer" are here, but don't let the phrase fool you. This hot time of year can be dangerous for your pup, says a Kansas State University veterinarian.

Affirmative action elicits bias in pro-equality Caucasians

50 minutes ago

New research from Simon Fraser University's Beedie School of Business indicates that bias towards the effects of affirmative action exists in not only people opposed to it, but also in those who strongly endorse equality.

Economical and agile offshore construction ship

1 hour ago

Siemens is currently installing the power supply and propulsion systems into a new multi-purpose offshore construction ship for Toisa Ltd. The ship, which is being built by the Korean company Hyundai Heavy ...

Recommended for you

User comments : 0