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London School of Hygiene & Tropical Medicine Malaria Centre

Malaria research in epidemiology

Evaluation of malaria diagnostic strategies using community health workers in South Central Asian where vivax is co-endemic with falciparum.

LSHTM investigators:
Toby Leslie, Amy Mikhail, Chris Whitty & Mark Rowland.
External collaborators:
HealthNet TPO; MERLIN & Health Protection and Research Organisation.
Funding body:
The Bill & Melinda Gates Foundation through the ACT Consortium.

In many low-resource settings where health services may be inaccessible, community health workers are relied upon to provide a range of services amongst which is the diagnosis and treatment of malaria.

Until very recently this diagnosis was almost always based on clinical signs and symptoms of the patient. The clinical method of diagnosis based on symptoms alson, especially in areas with low malaria transmission, is notoriously inaccurate and results in up to 95% of patients being misdiagnosed with malaria when, in fact, the patient has some other cause of disease which may include severe bacterial diseases.

In partnership with three NGOs in Afghanistan, members of the malaria centre are undertaking a large-scale cluster randomised field trial to assess whether RDTs are appropriate tools for community health workers. The study is conducted amongst ~400 health workers who are administratively attached to 22 clinics in two provinces in Afghanistan. The primary outcome is the proportion of patients who are appropriately treated for their condition.

The project is nearing its midpoint and results will be released in the coming year.