Malaria: Diagnosis, test therapy

In endemic regions fever, muscle pain, or even generally feeling unwell are often attributed to "malaria". An anti-malaria treatment is then instituted, without obtaining confirmation of the diagnosis or often even without considering alternative diseases. The argument given is that such a treatment can do no harm, that the diagnosis of malaria is always probable because the disease is common, and that this is a good strategy for first-line care. Each of these arguments can be defended to a certain extent, but in this way often useless and sometimes expensive treatments with potential side effects are administered. Not recognising and treating other diseases (borreliosis, rickettsiosis, kidney infections, amoebic liver abscess, pneumonia, septicaemia and so on) is a daily reality in many tropical regions. The over-diagnosis of malaria often leads to under-diagnosis of other treatable disorders. It is sometimes stated that fever which does not disappear after three days adequate therapy, is not malaria. The problem with this attitude is of course "adequate": the problem of drug-resistant malaria and malaria accompanied by complications (e.g. septicaemia).

Category: Medicine Notes