Teaching Health Workers Malaria Diagnosis

0108 M alaria kills over one million people in Africa each year and contributes 10% of the continent's burden of disease [1]. One of the factors that affects the morbidity and mortality rate is incorrect diagnosis [2]. In this article, we describe a freely available online training tool for health professionals to learn malaria diagnosis. We describe why we launched it and discuss how it is being used. Malaria affects at least 200–300 million people every year and causes from 1–2 million deaths—mostly children under fi ve and pregnant women in sub-Saharan Africa [1]. These deaths largely occur in remote rural areas with poor access to health services. In non-pregnant adults, although mortality rates are lower, the debilitating disease affects quality of life. The economic burden is also extremely high, accounting for a reduction of 1.3% in the annual economic growth rate of countries where malaria is endemic [3]. Malaria costs Africa more than US$12 billion every year in lost GDP, even though it could be controlled for a fraction of that sum [1]. Malaria is not limited to Africa—40% of the world's population is at risk of acquiring the disease [4,5]—and it is crucial for all physicians, medical scientists, and other healthcare professionals to be alert to the diagnosis. In addition, each year, 25–30 million people from non-tropical countries visit areas where malaria is endemic [6], and between 10,000 and 30,000 contract malaria [7]. Some 90% of infected travellers do not become ill until they return home; this " imported malaria " is easily treated, but only if it is diagnosed promptly [2,8]. Despite the efforts of a global campaign to roll back the disease, the number of deaths from malaria is increasing in Africa [9]. This statistic highlights the importance of local capacity to diagnose and treat malaria in order to prevent illness and death [10]. In many parts of the world, education about malaria diagnosis and treatment is limited—and the incorrect diagnosis of malaria by clinical, laboratory staff, and other healthcare workers can contribute to morbidity and mortality [2,11]. There is another important reason why correct diagnosis matters. Because of rising drug resistance in Africa, the conventional drugs for treating malaria—chloroquine and sulfadoxine-pyrimethamine—are now failing in up to 80% of cases [12]. There is a highly effective alternative to these drugs, which is artemisinin-based combination therapy (ACT) [13], but ACT is expensive (an adult dose of chloroquine …