Scientists caution on malaria diagnosis

Researchers at the Ifakara Health Institute(IHI) have pointed out possible challenges in malaria diagnosis and treatment of the patients who are tested malaria negative but they have acute fever. PHOTO|FILE

Dar es Salaam. With most people believeing that the first malaria symptom is fever, researchers in the country have warned that most of the acute fevers are due to other infectious diseases — some of which are life-threatening and can not be treated with anti-malarial drugs.

Researchers at the Ifakara Health Institute(IHI) have pointed out possible challenges in malaria diagnosis and treatment of the patients who are tested malaria negative but they have acute fever.

Until recently, malaria has been so prevalent in many African countries that health workers assumed any child with a fever had it.

It was seen that, although malaria is declining but there is the huge usage of anti-malaria drugs in most of the Sub-Saharan countries due to the poor diagnosis and the expected disease which is malaria.

In the styudy which was done at Dar es Salaama and Ifakara from April to August 2008, and published in February 27, 2014 at the New England Journal of Medicine it was revealed that most of the patient who had fever, they tested negative to Malaria but they were given improper drugs.

Dr Nicodem Govella, Senior Researcher and Head of the Environmental Health and Ecological Sciences Thematic Group at IHI said, it is a challenge in the field of Malaria because most of those who are tested negative with malaria are still given anti-malaria drugs and in future they become drug resistant.

He said, if all non-malaria fever are treated with anti malaria drugs, then there is a possibility that many people are not given proper medication for their diseases.

He said, there is the need for the health providers to asure themselves on the type of fever the patient has instead of giving them antibiotics of anti-malaria drugs.

“The diversity of the causes of fever, most of which cannot be diagnosed on clinical grounds alone, calls for the development of point-of-care tests” he said

He warned the public not to take anti-malaria drug whenever they feel to habe high fever.

He added that, health stakeholders need to know the possible causes of other type of fever rather than malaria instead of assuming and treating wrong diseases.

In the study acute respiratory infection was the most frequent diagnosis, made in 625 of 1005 patients (62.2 per cent Other diagnoses were distributed as follows: 134 of 1005 (13.3 per cent) children had  a systemic infection, 120 (11.9 per cent) had nasopharyngeal viral infection, 105 (10.5 per cent) had malaria, 103 (10.3 per cent) had gastroenteritis, 59 (5.9 per cent) had urinary tract infection, 37 (3.7 per cent) had typhoid fever, 15 (1.5 per cent) had skin or mucosal infection, and 2 (0.2 per cent) had meningitis.

In Dar es Salaam and Ifakara, most of the children diagnosed with fever probably had a viral illness and thus required neither an antimalarial agent nor an antibiotic.

Stakeholders have thus recognized the need for an improved understanding of nonmalarial fever, both to make useof the best care and to reduce inappropriate antibiotic use.

“Their tendency is to prescribe an antibiotic instead of an anti-malarial“which is also bad, because we just shift from one problem to the other.”,” said infectious disease expert Valerie D’Acremont with the Swiss Tropical and Public Health Institute, who did the reserch in Tanzania.

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The Citizen