ArticleThe American journal of tropical medicine and hygiene2017
The Impact of Introducing Malaria Rapid Diagnostic Tests on Fever Case Management: A Synthesis of Ten Studies from the ACT Consortium.
Article in The American journal of tropical medicine and hygiene, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- Pooled it
- Non-malarial febrile illness: a systematic review of published aetiological studies and case reports from Africa, 1980-2015.BMC medicine · 2020Pooled it
- Impact of the Introduction of a Package of Diagnostic Tools, Diagnostic Algorithm, and Training and Communication on Outpatient Acute Fever Case Management at 3 Diverse Sites in Uganda: Results of a Randomized Controlled Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Trial
- Community-Based Malaria Testing Reduces Polypharmacy in a Population-Based Survey of Febrile Illness in Western Kenya.International journal of public health · 2022Trial
- Subsidise the test, the treatment or both? Results of an individually randomised controlled trial of the management of suspected malaria fevers in the retail sector in western Kenya.BMJ global health · 2020Trial
- Article
- False-positive Malaria Rapid Diagnostic Tests are Prevalent Among Children Under 5 Years of Age in Uganda.The Journal of infectious diseases · 2026Article
- Positive tests are all alike, every negative test is negative in its own way: lack of confidence in negative malaria rapid diagnostic tests in the Democratic Republic of the Congo.Malaria journal · 2026Article
- Bridging the diagnostic gap: diagnostic capacity and pediatric quality of care in LMICs.BMC medicine · 2025Article
- Tracing epistemic injustice in global antimicrobial resistance research.Trends in microbiology · 2025Article
- Diagnostic accuracy ofExperimental biology and medicine (Maywood, N.J.) · 2025Article
- Article
- Receipt of antimalarials among children aged 6-59 months in Nigeria from 2010 to 2021.Malaria journal · 2024Article
- Health workers' adherence to malaria case management protocols in Northern Sudan: a qualitative study.Malaria journal · 2024Article
- Challenges in Diagnosing and Treating Acutely Febrile Children with Suspected Malaria at Health Care Facilities in the Lake Mwanza Region of Tanzania.The American journal of tropical medicine and hygiene · 2024Article
- Assessing availability, prices, and market share of quality-assured malaria ACT and RDT in the private retail sector in Nigeria and Uganda.Malaria journal · 2024Article
- Health workers' adherence to the malaria test, treat and track strategy during the COVID-19 pandemic in malaria high transmission area in Eastern Uganda.Malaria journal · 2023Article
- Perspective on the Integration of Diagnostic Algorithms for Fever Management.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Stakeholders' perception of a total market approach to HIV self-testing (HIVST) for the private sector in Nigeria.BMC public health · 2023Article
- The private sector market for malaria rapid diagnostic tests in Nigeria: results of the 2018 market survey.Malaria journal · 2022Article
Corrections and comments
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Authors and funding
35 authors at 16 institutions in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Since 2010, the World Health Organization has been recommending that all suspected cases of malaria be confirmed with parasite-based diagnosis before treatment. These guidelines represent a paradigm shift away from presumptive antimalarial treatment of fever. Malaria rapid diagnostic tests (mRDTs) are central to implementing this policy, intended to target artemisinin-based combination therapies (ACT) to patients with confirmed malaria and to improve management of patients with nonmalarial fevers. The ACT Consortium conducted ten linked studies, eight in sub-Saharan Africa and two in Afghanistan, to evaluate the impact of mRDT introduction on case management across settings that vary in malaria endemicity and healthcare provider type. This synthesis includes 562,368 outpatient encounters (study size range 2,400-432,513). mRDTs were associated with significantly lower ACT prescription (range 8-69% versus 20-100%). Prescribing did not always adhere to malaria test results; in several settings, ACTs were prescribed to more than 30% of test-negative patients or to fewer than 80% of test-positive patients. Either an antimalarial or an antibiotic was prescribed for more than 75% of patients across most settings; lower antimalarial prescription for malaria test-negative patients was partly offset by higher antibiotic prescription. Symptomatic management with antipyretics alone was prescribed for fewer than 25% of patients across all scenarios. In community health worker and private retailer settings, mRDTs increased referral of patients to other providers. This synthesis provides an overview of shifts in case management that may be expected with mRDT introduction and highlights areas of focus to improve design and implementation of future case management programs.
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Registered trials
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