The problem, the consequences, and rapid testing solutions
Malaria is a preventable and treatable infectious disease transmitted by mosquitoes that kills more than one million people each year, most of them in sub-Saharan Africa, where malaria is the leading cause of death for children under five.
Because malaria is a global crisis that affects mostly poor women and children, malaria perpetuates a vicious cycle of poverty in the developing world. Malaria related-illnesses and mortality cost Africa’s economy alone USD 12 billion per year.1
With the distribution of more than 290 million mosquito nets in Africa between 2008 and 2010, significant progress was made towards achieving the target of universal bed net coverage for at-risk population groups. Indoor residual spraying, another highly cost-effective control intervention, has also been significantly scaled up, helping to cut malaria cases and deaths in high-transmission areas. At the same time, however, the scale-up of diagnostic testing, treatment and surveillance has not received the same degree of attention.2
In the past, fever was equated with malaria in many endemic countries. However, recent control efforts have significantly reduced the malaria burden – even in high transmission areas of Africa. In these countries, most fever episodes seen at health facility or community level may be therefore no longer due to malaria. The commonest cause of fever in malaria-negative children is a viral infection.3 It has become clear that continued presumptive treatment of malaria would lead to both drug wastage and under-treatment of other febrile illnesses.2
While achieving universal access to malaria diagnostic testing will not be easy, some countries have already shown that is can be done. In Senegal, following the introduction of malaria rapid diagnostic tests (RDTs) in 2007, malaria diagnostic testing rates rose rapidly from 4% to 86% (by 2009); the prescription of ACT dropped throughout this period from 73% of malaria-like febrile illness to 32%, reaching close equivalence to confirmed malaria (30% of 585,000 suspected fever cases).
More than 500,000 courses of inappropriate ACT prescription were averted.2
In early 2010, WHO recommended that every suspected malaria case be confirmed by microscopy or an RDT prior to treatment. In recent years, the availability of high-quality, inexpensive RDTs has made it possible to significantly improve and expand diagnostic testing across all levels of the health system, from district hospitals to community-based programmes.2
The SD BIOLINE Malaria rapid tests from Alere are the most preferred Malaria RDTs in the world. Based on the outstanding quality performance, SD BIOLINE Malaria Ag P.f. is the first test in the world to complete the WHO prequalification process, and the BinaxNOW® Malaria test is the first and only FDA-cleared Malaria RDT.
- Roll Back Malaria – The Global Partnership for a Malaria-free World. Malaria Messages [Online] Available at: http://www.rbm.who.int/malariaMessages.html Date accessed: 22 Jul 2014
- World Health Organization (WHO) T3: Test. Treat. Track. Scaling up diagnostic testing, treatment and surveillance for malaria (2012) Available at: http://www.who.int/malaria/publications/atoz/t3_brochure/en/ Date accessed: 22 Jul 2014.
- WHO (2011. Rev. Feb 2013) Universal access to malaria diagnostic testing – An operational manual. Available at: http://www.who.int/malaria/publications/atoz/9789241502092/en/ Date accessed: 22 Jul 2014.