Rapid diagnostic tests versus clinical diagnosis for managing people with fever in malaria endemic settings

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There is some evidence to support the incorporation of Rapid Diagnostic Tests (RDTs) as part of the alogarithms in the treatment and management of malaria to reduce the presumptive prescription of antimalarial drugs. Improving the care of RDT negative patients could improve health outcomes in febrile children.

The World Health Organisation recommends and supports the importance of testing for malaria before treatment is offered to patients. However, due to insufficient resources for diagnostic tests especially in rural African settings, the majority of patients will be presumptively prescribed antimalarial drugs. Therefore, the use of Rapid Diagnostic Tests (RDTs) may help improve management of malaria especially in whom a diagnosis of malaria is objectively confirmed by RDTs. The aim of this review was to evaluate whether introducing RDTs into algorithms for diagnosing and treating people with fever improves health outcomes, reduces antimalarial prescribing, and is safe, compared to algorithms using clinical diagnosis.

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