I ntermittent presumptive treatment (IPT) in pregnancy involves giving a curative treatment dose of an effective antimalarial drug at predefi ned intervals during pregnancy. IPT in pregnancy was fi rst introduced in areas of high malaria transmission as a measure to reduce the adverse impact of Plasmodium falciparum malaria based on trials showing that IPT could reduce anaemia in young children...

BACKGROUND Confirmation of malaria and appropriate treatment are keys to malaria control. OBJECTIVE To determine the practice of malaria diagnosis and treatment in a Nigerian tertiary hospital. MATERIALS AND METHODS Retrospective review of patients' records at the Children's Clinic in UNTH. RESULTS Out of 6,684 children seen within the one year reviewed period, children diagnosed with mal...

OBJECTIVE To compare the cost-effectiveness of malaria treatment based on presumptive diagnosis with that of malaria treatment based on rapid diagnostic tests (RDTs). METHODS We calculated direct costs (based on experience from Ethiopia and southern Sudan) and effectiveness (in terms of reduced over-treatment) of a free, decentralised treatment programme using artesunate plus amodiaquine (AS ...

OBJECTIVE To compare the impact of malaria rapid diagnostic tests (mRDTs), used by community health workers (CHWs), on the proportion of children <5 years of age receiving appropriately targeted treatment with artemisinin-based combination therapy (ACT), vs. presumptive treatment. METHODS Cluster-randomized trials were conducted in two contrasting areas of moderate-to-high and low malaria tra...

BACKGROUND TO THE DEBATE Current guidelines recommend that all fever episodes in African children be treated presumptively with antimalarial drugs. But declining malarial transmission in parts of sub-Saharan Africa, declining proportions of fevers due to malaria, and the availability of rapid diagnostic tests mean it may be time for this policy to change. This debate examines whether enough evi...

BACKGROUND TO THE DEBATE Current guidelines recommend that all fever episodes in African children be treated presumptively with antimalarial drugs. But declining malarial transmission in parts of sub-Saharan Africa, declining proportions of fevers due to malaria, and the availability of rapid diagnostic tests mean it may be time for this policy to change. This debate examines whether enough evi...

Eighty adults in areas of Kenya where malaria is holoendemic received presumptive treatment with atovaquone-proguanil and were followed closely. The time to the first Plasmodium falciparum parasitemia was 32 days. This prolonged prophylaxis period has implications for study design when used in malaria intervention trials and cautiously suggests clinical investigation of potential preexposure pr...