Improving the quality of malaria diagnosis and laboratory services in resource-poor countries.
Abstract
Improving laboratory services and promoting accurate diagnosis of malaria at community level will save lives and prevent wastage of valuable resources. Increasing levels of resistance to cheap, first-line antimalarials means that many poor countries must promote new, more expensive treatment in the form of Artemisinin-based Combination Therapies (ACTs). Due to the resultant rising costs, it is no longer feasible to treat all fevers as malaria; the current high levels of misdiagnosis are unsustainable. The need, therefore, for improved diagnostic tools that can be used at community level has never been greater.
One million deaths per year are caused by malaria alone. In Sub-Saharan Africa more than 80 per cent of individuals self-treat fevers with antimalarial drugs without seeking health care in the formal sector. Self-treatment results in high levels of over-diagnosis of malaria, treating all fevers as malaria masks other underlying and potentially fatal conditions, and doing so is a significant waste of public and private resources.
The importance of accurate diagnosis of all the major diseases cannot be underestimated, and efficient laboratory testing is vital to identifying and treating life-threatening illnesses. Laboratory services in many low-income countries are often run down and yet they are critical for public health, disease control and surveillance as well as guiding patient diagnosis and care.
Poor quality laboratory services have the greatest negative impact on poor and vulnerable people because these people carry the largest burden of ill health. The effective diagnosis of malaria and other life-threatening illnesses at both community and laboratory level will help reduce this burden. There is indirect evidence to suggest that the mismanagement of malaria and other fevers contributes to a vicious cycle of deepening poverty and increasing ill health.
Since 1999 the Malaria Knowledge Programme has been working in Ghana and Malawi to increase the effectiveness of laboratory systems and diagnostics tools.
Citation
Bates, I.; Barnish, G. Improving the quality of malaria diagnosis and laboratory services in resource-poor countries. (2005)
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