Testing for malaria reduces over prescription by more than 70%

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Using malaria rapid diagnostic tests (RDTs) in registered drug shops in a highly endemic region in Uganda substantially reduced over-diagnosis of malaria, improving the use of valuable malaria drugs, according to a new study published in PLOS ONE.

Most of the 15,000 patients that visited drug shops with a fever chose to buy an RDT when offered one by the trained vendors taking part in the study. Once they performed the test, results showed that less than 60% of the patients had malaria. The vendors usually complied with the test results, reducing over prescription of malaria drugs by 73%.

The researchers from the Artemisinin-based Combination Therapy (ACT) Consortium at the Ministry of Health in Uganda and the London School of Hygiene and Tropical Medicine in the UK carried out the study.

Lead author, Prof. Anthony Mbonye from the Ugandan Ministry of Health, said: ‘Our findings show that it is feasible to collaborate with the private health sector and introduce malaria RDTs in drug shops. The next step is to refine the strategy and understand the cost implications of scaling it up in Uganda. Our long-term aim is to provide evidence to help the World Health Organization (WHO) develop guidance to improve malaria treatment in the private sector.’

Dr. Sian Clarke from the London School of Hygiene and Tropical Medicine, also a principal investigator in the research, said: ‘These tests alone will not improve the treatment of other diseases. We now need to continue working with the Ministry of Health to investigate how to improve our approach and expand it to other common illnesses.’

At present, drug shop vendors usually treat patients based on their signs and symptoms without testing their blood for the presence of malaria parasites, as recommended by the WHO. This can result in patients with a fever being over-diagnosed with malaria and purchasing a treatment, which they don’t need.

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