The Malaria Epidemic Is Misdiagnosed By Thousands

(CTN News) – About a third of children diagnosed with severe malaria in sub-Saharan Africa have a different infection, raising concerns about their treatment.

A total of 234 million people caught malaria globally in 2021, leading to 593,000 deaths, including around 450,000 children under five.

Researchers have suggested that the child death toll and case count may have been misattributed. Poor diagnostics for infections with similar symptoms, particularly bacteria, are the problem, not a lack of tests.

Malaria is ubiquitous in sub-Saharan Africa, according to Sir Nick White, professor of tropical medicine at Mahidol University Thailand and the University of Oxford.

As a result, you are constantly infected. Is your body infested with parasites? Are you suffering from  parasite infection? ”

We over diagnose because it’s so common, we have a test, and we don’t have a test for most of the other things that cause fever,” said Sir Nick.

Currently, the World Health Organization recommends that all children who have severe malaria receive both antibiotics and antimalarials to combat this risk.

Ignoring concerns and advice

According to the Lancet letter, this frequently does not happen, especially in remote regions of sub-Saharan Africa.

According to the letter, “Unfortunately, this advice is often not followed, or antibiotics are delayed until a child deteriorates.

A positive blood test becomes, perversely, a risk factor for deaths from bacterial sepsis if children don’t receive effective antibiotics immediately.

As a clinical epidemiologist at Liverpool School of Tropical Medicine, Prof Feiko ter Kuile said it “makes perfect sense” that many children with severe  die of undiagnosed causes.

It is very likely that a large fraction of people in rural hospitals do not have severe malaria – despite carrying the parasite – and are suffering from other causes of severe illness such as sepsis.

Recent studies suggest roughly one-third of children with severe  may also be suffering from sepsis, rather than malaria.

Malaria isn’t severe in a third of kids

People with sickle cell disease are more likely to be resistant to malaria due to the prevalence of the blood disorder. According to researchers, the trait was “extremely low” among children who they believed had, but far higher in groups who did not think they had it.

“We looked only at children who had and found it reduced mortality by a third,” said Sir Nick. “There was no impact on children who were thought to be free of malaria. The severe illness they suffer from isn’t caused by malaria, as you would expect.

As a result of both of these inferences, we can conclude that about a third of kids labelled as having severe  don’t actually have it.

According to him, broad spectrum antibiotics as well as could potentially save thousands of lives, and he urged health authorities to follow this recommendation. In comparison to the number of lives saved, Sir Nick said the potential for accelerating antimicrobial resistance is minimal.

“Simple blood tests can help identify these misdiagnosed children, but the implications for clinical management are clear: children with suspected severe malaria must immediately be treated with both and broad-spectrum antibiotics.”

In rural areas, he said insufficient access to care is the biggest killer.

In Africa, there is limited access to secondary care regardless of the severity of the disease – malaria, bacteria, or viral infections, he said. The problem is that.”

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