Systematic reviews of diagnostic test accuracy for evidence-based diagnostic practice in Africa

© 2012. The Authors. Licensee: AOSIS OpenJournals. This work is licensed under the Creative Commons Attribution License. In 2009, a debate started about whether there was enough evidence to change current guidelines, from presumptive malarial treatment of children under 5 years who present with fever, to testing these children before treating them.1,2 A major argument against this policy change was the lack of confidence in the performance of the available rapid diagnostic tests to diagnose malaria in children accurately. This debate neatly illustrates one of the many diagnostic dilemmas with which resource-poor countries struggle. It also illustrates the need for more, and better, evidence about diagnostic questions in these countries.