Diagnosis and Treatment
Prompt and accurate diagnosis of malaria is part of effective disease management and will, if implemented effectively, help reduce unnecessary use of antimalarial medicines. The two diagnostic approaches currently used are based on
- the symptoms and signs of the disease - i.e. a clinical diagnosis and
- detection of the causative parasite or its product(s).
The most commonly used being microscopic diagnosis, and more recently rapid diagnostic tests based on immunochromatographic techniques.
Once diagnosed as malaria the patient should be treated early with safe and effective medicine (The goal of the Roll Back Malaria Partnership in this context is to assure effective treatment within 24 hours of the onset of symptoms). This is because a delay in treatment of uncomplicated malaria, specially in the non-immune patient could result in progression to severe disease which is associated with a high case fatality rate.
Malaria is a treatable but complex disease. Parasitic resistance has grown throughout sub-Saharan Africa to chloroquine and sulfadoxine-pyremethamine, leading to treatment failure against P. falciparum malaria, the deadliest form of the disease. Underdeveloped rural areas with high transmission rates often lack clinics, trained specialists or diagnostic tools.
For all of these reasons, the World Health Organization (WHO) recommends Artemisinin-based Combinational Therapies (ACTs) for the presumptive treatment of uncomplicated P. falciparum malaria. The WHO also recommends that countries change anti-malarial treatment policy, preferably to ACTs, when existing drugs prove to be less than 90 percent effective.
According to data of the WHO, by June 2008, only four countries worldwide had not yet adopted ACTs as the first-line treatment for P.falciparum malaria.
The production and distribution of substandard and counterfeit drugs, including ACTs, is a vast, increasing and underreported, problem. Adulterated medicines contain little or none of the active ingredients found in their branded equivalent, and often have adverse health effects.
