Comments on: Scaling lab diagnosis of malaria and the end of presumptive treatment in Africa? http://topnaman.com/diagnosis/scaling-lab-diagnosis-of-malaria-and-the-end-of-presumptive-treatment-in-africa/ malaria news and discussion Thu, 12 Aug 2010 19:17:37 +0000 hourly 1 By: naman http://topnaman.com/diagnosis/scaling-lab-diagnosis-of-malaria-and-the-end-of-presumptive-treatment-in-africa/comment-page-1/#comment-2797 naman Wed, 04 Feb 2009 19:04:45 +0000 http://topnaman.com/?p=110#comment-2797 Gil, thanks for your comments. As you note some situations will warrant presumptive treatment where under treatment could lead to excess mortality in the community, but ultimately diagnostics need to be strengthened. You mention training volunteers in microscopy, but this can be difficult. What is your experience with rapid tests (RDTs) for malaria where you work in Phillipines? Have they been introduced, are they for both PF and PV, and do health workers trust their results? Gil,

thanks for your comments. As you note some situations will warrant presumptive treatment where under treatment could lead to excess mortality in the community, but ultimately diagnostics need to be strengthened. You mention training volunteers in microscopy, but this can be difficult. What is your experience with rapid tests (RDTs) for malaria where you work in Phillipines? Have they been introduced, are they for both PF and PV, and do health workers trust their results?

]]> By: Gil M. dela Cruz http://topnaman.com/diagnosis/scaling-lab-diagnosis-of-malaria-and-the-end-of-presumptive-treatment-in-africa/comment-page-1/#comment-2780 Gil M. dela Cruz Wed, 04 Feb 2009 13:25:19 +0000 http://topnaman.com/?p=110#comment-2780 Presumptive treatment deserves a second thought. It is a blind treatment. Nobody knows after treatment whether the disease is malaria or not. If it is considered as malaria then the data of malaria incidence will bloat. If we are treating non malaria with anti malaria drug then we are exposing the patient to risk of adverse drug reaction and the risk of development of drug resistance. Our experience in the country with presumptive diagnosis is not very good because with these presumptions basis for control method then will be erroneous resulting to further wastage of resources. But if the situation warrants presumptive treatment then it is the best for the community but there is a need to develop local capacity even volunteers to do diagnostic microscopy. By the way I am from the Philipppines. We trained volunteer microscopist in areas hardly accessible to the regular health system. It is supported by the Global Fund. As a result access to quality diagnostic microscopy improved tremendously and presumptive treatment was abondoned. Presumptive treatment deserves a second thought. It is a blind treatment. Nobody knows after treatment whether the disease is malaria or not. If it is considered as malaria then the data of malaria incidence will bloat. If we are treating non malaria with anti malaria drug then we are exposing the patient to risk of adverse drug reaction and the risk of development of drug resistance. Our experience in the country with presumptive diagnosis is not very good because with these presumptions basis for control method then will be erroneous resulting to further wastage of resources. But if the situation warrants presumptive treatment then it is the best for the community but there is a need to develop local capacity even volunteers to do diagnostic microscopy. By the way I am from the Philipppines. We trained volunteer microscopist in areas hardly accessible to the regular health system. It is supported by the Global Fund. As a result access to quality diagnostic microscopy improved tremendously and presumptive treatment was abondoned.

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