ArticleAnnals of clinical microbiology and antimicrobials2019
The effect of malaria rapid diagnostic tests results on antimicrobial prescription practices of health care workers in Burkina Faso.
Article in Annals of clinical microbiology and antimicrobials, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Synthesis and Meta-analysis of 3 Randomized Trials Conducted in Burkina Faso, Ghana, and Uganda Comparing the Effects of Point-of-Care Tests and Diagnostic Algorithms Versus Routine Care on Antibiotic Prescriptions and Clinical Outcomes in Ambulatory Patients <18 Years of Age With Acute Febrile Illness.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Pooled it
- Impact of a package of point-of-care diagnostic tests, a clinical diagnostic algorithm and adherence training on antibiotic prescriptions for the management of non-severe acute febrile illness in primary health facilities during the COVID-19 pandemic in Burkina Faso.BMC infectious diseases · 2024Trial
- A Randomized Trial to Assess the Impact of a Package of Diagnostic Tools and Diagnostic Algorithm on Antibiotic Prescriptions for the Management of Febrile Illnesses Among Children and Adolescents in Primary Health Facilities in Burkina Faso.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Trial
- Trial
- Assessment of the Prioritization of Diagnostics in National Action Plans for Antimicrobial Resistance.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Malaria and bacteremia in febrile children presenting at a teaching hospital in Kumasi, Ghana.BMC infectious diseases · 2026Article
- C-reactive protein, white blood cell counts and sequential interpretation of PfHRP2/pLDH for antibiotic stewardship in children under 5 years of age.BMC infectious diseases · 2026Article
- Antibiotic stewardship and point-of-care testing for children in 25 low-income and lower-middle-income countries: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Refining malaria diagnosis in high-transmission areas: a dual-approach with rapid diagnostic tests (RDTs) and dbPCR-NALFIA.Malaria journal · 2025Article
- Antibiotic use by clinical presentation across all healthcare providers in rural Burkina Faso: a healthcare visit exit survey.The Journal of antimicrobial chemotherapy · 2024Article
- Evaluating Antibiotic Misuse and Cost Analysis Among Hospitalized Dengue Virus-Infected Adults: Insights From a Retrospective Cohort Study.Open forum infectious diseases · 2024Article
- Modeling pediatric antibiotic use in an area of declining malaria prevalence.Scientific reports · 2024Article
- Perspective on the Integration of Diagnostic Algorithms for Fever Management.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Feasibility and Acceptability of a Strategy Deploying Multiple First-Line Artemisinin-Based Combination Therapies for Uncomplicated Malaria in the Health District of Kaya, Burkina Faso.Tropical medicine and infectious disease · 2023Article
- Request for Antimalarial Medicines and Their Dispensing Without a Prescription in Community Pharmacies in Rwanda.Integrated pharmacy research & practice · 2023Article
- Could combined rapid diagnostic testing for malaria and c-reactive protein be helpful for the diagnosis and management of febrile illnesses in children under-5 years of age in rural Burkina Faso?BMC infectious diseases · 2022Article
- Diagnostic Performance ofTropical medicine and infectious disease · 2022Article
- Antimicrobial Stewardship in Tropical Infectious Diseases: Focusing on Dengue and Malaria.Tropical medicine and infectious disease · 2022Review
- Use of WATCH antibiotics prior to presentation to the hospital in rural Burkina Faso.Antimicrobial resistance and infection control · 2022Observational
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundMalaria rapid diagnostic tests (RDT) are widely used in endemic areas in order to comply with the recommendation that malaria treatment should only be given after the clinical diagnosis has been confirmed by RDT or microscopy. However, the overestimation of malaria infection with the use of PfHRP2 based RDT, makes the management of febrile illnesses more challenging. This study aimed to assess the effect of the use of malaria RDT on antimicrobial prescription practices.
methodsA prospective study was conducted among febrile children under-5 years of age attending four health facilities and the referral hospital in the Nanoro Health District (Burkina Faso). To assess the effect of malaria RDT testing on the prescriptions of antimicrobials in febrile children, the initial diagnosis and antimicrobial prescriptions following a malaria RDT testing were recorded. The necessity of these prescriptions was subsequently checked by assessing the actual cause of fever by expert malaria microscopy and a microbiology analysis of blood, urine, stool and nasopharynx swabs that were collected from febrile cases to determine the actual cause of the fever episode.
resultsMalaria was diagnosed by nurses, who are the primary health care providers, with a malaria RDT in 72.7% (798/1098) of febrile children, but only 53.7% (589/1097) cases could be confirmed by expert microscopy. Health care workers were likely to prescribe antimalarials to malaria positive RDT compared to malaria negative RDT (RR = 7.74, p = 0.00001). Malaria negative RDT result had a significant influence on the antibiotic prescriptions (RR = 3.57, p = 0.0001). The risk of prescribing antimicrobials was higher in health facility level compared to referral hospital. By cross-checking of laboratory findings to antimicrobial prescriptions, an important part of children with positive bacterial infection have received antibiotic prescriptions although the majority without any infection have also received antibiotics.
conclusionDespite the good attitude of health care workers to adhere to diagnostic test results, antimalarials and antibiotics remain inappropriate prescribed to febrile children. The low specificity of malaria RDT used could be an important cause of these practices.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.