Diagnosis and Treatment of Malaria
Non-Malarial Fevers and Low Parasite Levels in the Amazon
One of the outstanding problems in malaria elimination is to provide precise, robust and reliable tools for parasite diagnostics in rural and resource limited settings. While cases of high parasite density can be detected by microscopy and rapid diagnostics tests, many asymptomatic infections escape detection by the tests currently available.
These sub-patent infections are increasingly acknowledged as a previously neglected reservoir for onward transmission.
With reduced transmission intensity, the proportion of individuals seeking healthcare for acute febrile illness not caused by malaria will increase. This is not being addressed adequately in the rural Amazon region, where health systems are precarious and the only health diagnostic tool provided at most health posts is for malaria infection.
Previous research performed in the region has pointed to the great diversity of infectious agents causing acute fever, from arbovirus to bacteria. At the same time Swiss TPH studies have shown the usefulness of clinical algorithms for the improvement of management of febrile cases (Rambaud-Althaus et al. 2015). The project aims to validate new approaches integrating novel diagnostics and clinical management.
Improvement in Quality of Malaria Patient Management
The effective coverage of Artemesinin-based combination therapy in Tanzania is very low because of health system failures. In response to this, and as part of the INDEPTH Network Effectiveness and Safety Studies in Africa we are working on an intervention trial to improve provider compliance and patient adherence in the Rufiji District.