Overdiagnosis and overtreatment of malaria is a major problem in children in malaria-endemic countries. This retrospective study identified children who were admitted with fever and were treated with or without anti-malarial medications and discharged at the Paediatric Unit of the Effia-Nkwanta Regional Hospital. The medical records of all children were searched, retrieved and assessed. A total of 1160 records from children (age range, 0–12 years) were reviewed and evaluated. Of the total number, 21.3% had laboratory confirmed malaria, 38.4% were malaria negative, while 40.3% had no malaria tests performed. In addition, the results showed that 4.5% of the laboratory confirmed malaria positive cases were not given anti-malarial medication while 84.1% of the malaria negative cases were given these incorrectly. Furthermore, 78.2% of the children with no malaria tests were prescribed anti-malarial medication. The presumptive diagnosis of malaria should be abandoned and the installation of a functional laboratory services promoted.
ReyburnHMbatiaRDrakeleyC. Overdiagnosis of malaria in patients with severe febrile illness in Tanzania: a prospective study. BMJ2004; 329: 1212–1212.
4.
WhittyCJChandlerCAnsahELeslieTStaedkeSG. Deployment of ACT antimalarials for treatment of malaria: challenges and opportunities. Malar J2008; 7(Suppl. 1): S7–S7.
5.
BisoffiZGobbiFAnghebenAVan den EndeJ. The role of rapid diagnostic tests in managing malaria. PLoS Med2009; 6: e1000063–e1000063.
6.
NankabirwaJZurovacDNjoguJN. Malaria misdiagnosis in Uganda–implications for policy change. Malar J2009; 8: 66–66.
7.
OladosuOOOyiboWA. Overdiagnosis and overtreatment of malaria in children that presented with fever in Lagos, Nigeria. ISRN Infectious Diseases2013; 2013: 914675–914675.
8.
BaidenFMalmKBart-PlangeC. Shifting from presumptive to test-based management of malaria - technical basis and implications for malaria control in Ghana. Ghana Med J2014; 48: 112–122.
ChandramohanDJaffarSGreenwoodB. Use of clinical algorithms for diagnosing malaria. Trop Med Int Health2002; 7: 45–52.
13.
A-ElgayoumSMEl-Feki AelKMahgoubBAEl-Rayah elAGihaHA. Malaria overdiagnosis and burden of malaria misdiagnosis in the suburbs of central Sudan: special emphasis on artemisinin-based combination therapy era. Diagn Microbiol Infect Dis2009; 64: 20–26.
AbrehaTAlemayehuBTadesseY. Malaria diagnostic capacity in health facilities in Ethiopia. Malar J2014; 13: 292–292.
17.
EnglishMReyburnHGoodmanCSnowRW. Abandoning presumptive antimalarial treatment for febrile children aged less than five years–a case of running before we can walk?PLoS Med2009; 6: e1000015–e1000015.
18.
D’AcremontVLengelerCMshindaHMtasiwaDTannerMGentonB. Time to move from presumptive malaria treatment to laboratory-confirmed diagnosis and treatment in African children with fever. PLoS Med2009; 6: e252–e252.
19.
PolageCRBedu-AddoGOwusu-OforiA. Laboratory use in Ghana: physician perception and practice. Am J Trop Med Hyg2006; 75: 526–531.
20.
ChandlerCIJonesCBonifaceGJumaKReyburnHWhittyCJ. Guidelines and mindlines: why do clinical staff over-diagnose malaria in Tanzania? A qualitative study. Malar J2008; 7: 53–53.
21.
DeruaYAIshengomaDRRwegoshoraRT. Users’ and health service providers’ perception on quality of laboratory malaria diagnosis in Tanzania. Malar J2011; 10: 78–78.
22.
FonjungoPNKebedeYMesseleT. Laboratory equipment maintenance: a critical bottleneck for strengthening health systems in sub-Saharan Africa?J Public Health Policy2012; 33: 34–45.
23.
GoveS. Integrated management of childhood illness by outpatient health workers: technical basis and overview. The WHO Working Group on Guidelines for Integrated Management of the Sick Child. Bull World Health Organ1997; 75(Suppl. 1): 7–24.
NdyomugyenyiRMagnussenPClarkeS. Diagnosis and treatment of malaria in peripheral health facilities in Uganda: findings from an area of low transmission in south-western Uganda. Malar J2007; 6: 39–39.
26.
ReddSCBlolandPBKazembePNPatrickETembenuRCampbellCC. Usefulness of clinical case-definitions in guiding therapy for African children with malaria or pneumonia. Lancet1992; 340: 1140–1143.
27.
HoghBMarbiahNTBurghausPAAndersenPK. Relationship between maternally derived anti-Plasmodium falciparum antibodies and risk of infection and disease in infants living in an area of Liberia, west Africa, in which malaria is highly endemic. Infect Immun1995; 63: 4034–4038.
28.
Runsewe-AbiodunITOgunfoworaOBFetugaBM. Neonatal malaria in Nigeria–a 2 year review. BMC Pediatrics2006; 6: 19–19.
29.
OlaleyeBOWilliamsLAD’AlessandroU. Clinical predictors of malaria in Gambian children with fever or a history of fever. Trans R Soc Trop Med Hyg1998; 92: 300–304.
30.
MullerOTraoreCBecherHKouyateB. Malaria morbidity, treatment-seeking behaviour, and mortality in a cohort of young children in rural Burkina Faso. Trop Med Int Health2003; 8: 290–296.
31.
ClarkeSEBrookerSNjagiJK. Malaria morbidity among school children living in two areas of contrasting transmission in western Kenya. Am J Trop Med Hyg2004; 71: 732–738.
32.
AfoakwahRBoampongJNEgyir-YawsonANwaefunaEKVernerONAsareKK. High prevalence of PfCRT K76T mutation in Plasmodium falciparum isolates in Ghana. Acta Trop2014; 136: 32–36.
33.
GbotoshoGOHappiCTGaniyuAOgundahunsiOASowunmiAOduolaAM. Potential contribution of prescription practices to the emergence and spread of chloroquine resistance in south-west Nigeria: caution in the use of artemisinin combination therapy. Malar J2009; 8: 313–313.
34.
YeungSSocheatDMoorthyVSMillsAJ. Artemisinin resistance on the Thai-Cambodian border. Lancet2009; 374: 1418–1419.
35.
JonkmanAChibweRAKhoromanaCO. Cost-saving through microscopy-based versus presumptive diagnosis of malaria in adult outpatients in Malawi. Bull World Health Organ1995; 73: 223–227.
