ArticleMalaria journal2017
Assessment of the utility of a symptom-based algorithm for identifying febrile patients for malaria diagnostic testing in Senegal.
Article in Malaria journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 10 citations in OpenAlex.
- The WHO recommendation of home fortification of foods with multiple-micronutrient powders in children under 2 years of age and its effectiveness on anaemia and weight: a pragmatic cluster-randomized controlled trial.Public health nutrition · 2018Trial
- Smartphone conjunctiva photography for malaria risk stratification in asymptomatic school age children.NPJ digital medicine · 2025Article
- Development and validation of an online tool for assessment of health care providers' management of suspected malaria in an area, where transmission has been interrupted.Malaria journal · 2022Article
- A data quality assessment of the first four years of malaria reporting in the Senegal DHIS2, 2014-2017.BMC health services research · 2022Article
- Malaria Temporal Variation and Modelling Using Time-Series in Sussundenga District, Mozambique.International journal of environmental research and public health · 2021Article
- Trends in health workers' compliance with outpatient malaria case-management guidelines across malaria epidemiological zones in Kenya, 2010-2016.Malaria journal · 2020Article
- A Robust Estimator of Malaria Incidence from Routine Health Facility Data.The American journal of tropical medicine and hygiene · 2020Article
- Quality of malaria services offered in public health facilities in three provinces of Mozambique: a cross-sectional study.Malaria journal · 2019Article
- How Far Are We from Reaching Universal Malaria Testing of All Fever Cases?The American journal of tropical medicine and hygiene · 2018Article
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13 authors at 5 institutions in 2 countries.
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Abstract
backgroundMalaria rapid diagnostic tests (RDTs) enable point-of-care testing to be nearly as sensitive and specific as reference microscopy. The Senegal National Malaria Control Programme introduced RDTs in 2007, along with a case management algorithm for uncomplicated febrile illness, in which the first step stipulates that if a febrile patient of any age has symptoms indicative of febrile illness other than malaria (e.g., cough or rash), they would not be tested for malaria, but treated for the apparent illness and receive an RDT for malaria only if they returned in 48 h without improvement.
methodsA year-long study in 16 health posts was conducted to determine the algorithm's capacity to identify patients with Plasmodium falciparum infection identifiable by RDT. Health post personnel enrolled patients of all ages with fever (≥37.5 °C) or history of fever in the previous 2 days. After clinical assessment, a nurse staffing the health post determined whether a patient should receive an RDT according to the diagnostic algorithm, but performed an RDT for all enrolled patients.
resultsOver 1 year, 6039 patients were enrolled and 58% (3483) were determined to require an RDT according to the algorithm. Overall, 23% (1373/6039) had a positive RDT, 34% (1130/3376) during rainy season and 9% (243/2661) during dry season. The first step of the algorithm identified only 78% of patients with a positive RDT, varying by transmission season (rainy 80%, dry 70%), malaria transmission zone (high 75%, low 95%), and age group (under 5 years 68%, 5 years and older 84%).
conclusionsIn all but the lowest malaria transmission zone, use of the algorithm excludes an unacceptably large proportion of patients with malaria from receiving an RDT at their first visit, denying them timely diagnosis and treatment. While the algorithm was adopted within a context of malaria control and scarce resources, with the goal of treating patients with symptomatic malaria, Senegal has now adopted a policy of universal diagnosis of patients with fever or history of fever. In addition, in the current context of malaria elimination, the paradigm of case management needs to shift towards the identification and treatment of all patients with malaria infection.
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