Debate on treating fevers in African children
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A new debate in the open access journal PLoS Medicine questions whether all African children with fever should be treated presumptively with antimalarial drugs, or if treatment should wait until laboratory tests confirm malarial infection.
Blaise Genton and colleagues from Tanzania contend that declining malarial transmission rates in parts of sub-Saharan Africa and the availability of rapid diagnostic tests mean that it is time for the policy of presumptive treatment to change. That the proportion of fevers due to malaria has declined substantially, even in highly endemic areas, increases the relative likelihood of missing other potentially fatal diseases in children, argue the authors.
But Mike English and colleagues from Kenya disagree. They argue that there is not yet enough evidence to support abandoning presumptive treatment and that African health systems do not have the capacity to support a shift toward laboratory-confirmed rather than presumptive diagnosis and treatment of malaria in children under five. “If anxiety about drug costs (which are falling) and optimism that malaria is being defeated drive rapid policy change,” the authors argue, “this may result in hurried policy doing more harm than good.”
The next generation of case management guidelines for childhood illness need to be more locally informed, rather than relying on those centrally generated by organizations like the World Health Organization (WHO), argues a new essay published in the open access journal PLoS Medicine. Mike English and Anthony Scott from the KEMRI-Wellcome Trust Programme in Kenya
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The use of insecticide-treated bed nets (ITNs) to protect children from malaria has risen six-fold in the past seven years, according to research funded by the Wellcome Trust. Despite this success, however, 90 million children still do not have access to this simple protective tool, and remain at risk from the life-threatening disease. Malaria kills
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Malaria, one of the oldest diseases known to man, has shown no signs of slowing down as it ages. More than 1 million children die from malaria in sub-Saharan Africa each year, and in areas along the Thailand/Cambodian border multiple drug-resistant strains of the disease are becoming commonplace. With the previously mainstay antimalarial drug chloroquine
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