Malaria policymakers and clinicians are concerned about the clinical, financial and public health harms associated with over-treating malaria.
Over-treatment happens when a person who doesn’t have malaria is given antimalarial drugs unnecessarily. This could be a person who has malaria-like symptoms such as fever.
About 88% of the world’s malaria cases are found in Africa. As a result, over-treatment of malaria is most common on the continent.
There are three main issues with over-treatment.
The first is that because malaria has been so prevalent there is a danger that all fevers are diagnosed as being caused by the disease. This means that other serious infections could be missed. This is particularly true as the number of malaria cases has dropped in many countries.
Second, the currently recommended first-line antimalarial drugs – artemisinin-based combination therapies – are not cheap. Their unnecessary use leads to a waste of resources.
And third, in some countries, resistance against these drugs has emerged. They therefore need to be used sparingly.
To help overcome this problem the use of rapid diagnostic tests should be expanded. The tests have been around for at least six years and have changed the way that malaria is diagnosed. They can detect the presence of malaria within minutes and can be used in basic health care services in remote places.