Prescribing malaria medication to patients who don’t need it wastes precious resources in a country already dealing with drug shortages. It leaves patients untreated for the real cause of their sickness. And it can lead to drug resistance, making malaria parasites harder to eliminate when people really do contract the disease.
So why do health workers ignore negative test results?
Read more, via PRI’s The World.
The following is a response from a Ugandan clinic, written for the original article. I think a very valid point is being made; sometimes people don’t come back to the clinic for a second test, or if their symptoms worsen, and in these conditions it is better to treat more people than to under-treat.
From a clinic in Uganda:
The need for febrile patients to be promptly tested by a trained medic is a key message we give and repeat for youth, adults and guardians of children. All households need to understand the dangers of fevers or dehydration being ignored – and that not all fevers are caused by malaria. In Uganda, however, malaria is a very likely cause, alongside poor hygiene. Because of the parasite’s life cycle, a negative test that hour may need retesting within 24hours. For the community medic, such as Annet at Hope Clinic Lukuli, the danger is that the patient will not return for that second malaria test. This leads to the understandable pressure, and medical ethics dilemma, that presumptive treatment of malaria for that patient will not harm that patient but could protect them over the coming 24 hours. Intermittent Preventive Treatment for Malaria (IPTM) is a national directive during pregnancy – so being asked not to treat a febrile child is hard for medics to accept. Other causes of fever, including pneumonia and meningitis, can be screened for at the clinic during the laboratory’s daytime work but at night reliance is placed on malaria Rapid Diagnostic Tests (RTDs).