Can treatment of malaria be restricted to parasitologically confirmed malaria? A school-based study in Benin in children with and without fever

Malaria Journal

Research

Grace Abiou¹  Todoégnon Béhéton²  Jean-François Faucher³  Michel Cot⁴  Philippe Deloron⁴  Patrick Makoutode⁵  Edgard Ouendo⁵  Pascal Houzé⁶  Sandrine Houzé⁷ 

[1] Department of Parasitology, Faculty of Health Sciences, Cotonou, Benin;Institut de Recherche pour le Développement (IRD), UMR 216: Mother and Child face to tropical infections, Paris, France;Institut de Recherche pour le Développement (IRD), UMR 216: Mother and Child face to tropical infections, Paris, France;Departement of Infectious Diseases, Besançon University Medical Center, 25030, Besançon cedex, France;Institut de Recherche pour le Développement (IRD), UMR 216: Mother and Child face to tropical infections, Paris, France;Université Paris Descartes, Paris, France;Regional Public Health Institute of Ouidah, Benin;Saint-Louis Hospital biochemistry laboratory, Paris, France;Université Paris Descartes, Paris, France;Laboratory of Parasitology, AP-HP Bichat-C. Bernard Hospital, Paris, France;

关键词: Malaria;    Chloroquine;    Severe Malaria;    Rapid Diagnostic Test;    Index Group;   

DOI  :  10.1186/1475-2875-9-104

 received in 2009-10-21, accepted in 2010-04-21,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundApplying the switch from presumptive treatment of malaria to new policies of anti-malarial prescriptions restricted to parasitologically-confirmed cases is a still unsolved challenge. Pragmatic studies can provide data on consequences of such a switch. In order to assess whether restricting anti-malarials to rapid diagnostic test (RDT)-confirmed cases in children of between five and 15 years of age is consistent with an adequate management of fevers, a school-based study was performed in Allada, Benin.MethodsChildren in the index group (with fever and a negative RDT) and the matched control group (without fever and a negative RDT) were not prescribed anti-malarials and actively followed-up during 14 days. Blood smears were collected at each assessment. Self-medication with chloroquine and quinine was assessed with blood spots. Malaria attacks during the follow-up were defined by persistent or recurrent fever concomitant to a positive malaria test.Results484 children were followed-up (242 in each group). At day 3, fever had disappeared in 94% of children from the index group. The incidence of malaria was similar (five cases in the index group and seven cases in the control group) between groups. Self-medication with chloroquine and quinine in this cohort was uncommon.ConclusionsApplying a policy of restricting anti-malarials to RDT-confirmed cases is consistent with an adequate management of fevers in this population. Further studies on the management of fever in younger children are of upmost importance.

【 授权许可】

Unknown   
© Faucher et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.