Diagnostic testing to confirm malaria in symptomatic children younger than five in the African countries of Angola, Tanzania and Uganda would be cost-effective, according to a recent study at Emory’s Rollins School of Public Health.  

Victoria Phillips, PhD, associate professor of health policy and management and team used data from national Malaria Indicator Surveys to assess the cost effectiveness of the World Health Organization’s (WHO) 2010 recommendation that countries test children five years and under who present with malaria fever.  The policy was enacted in an effort to improve disease management, by confirming the diagnosis instead of treating cases presumptively with antimalarial drugs.

“We used a model that estimates the annual total costs and deaths averted by diagnostic testing in comparison to those averted by presumptive treatment for kids who present with malaria fever,” explains Phillips. “Using this model, we are able to outline possible treatment sequences, based on physician and consumer behavior, and based on the probabilities around these inputs, we can produce estimates of the cost and outcomes for alternative strategies.”

Results show that the likelihood that diagnostic testing will produce health gains at a reasonable price was 80 percent in Angola, 89 percent in Tanzania and 64 percent in Uganda, reflecting the relatively high prevalence of malaria in that country and low rates of clinician compliance with negative test results.

“Factors such as improved logistical management to ensure a reliable testing kit supply, clinicians’ adherence to test results, and of course, provider education and overall training of health care workers are all essential for successful disease management and cost-effectiveness,” says Phillips.  “Shifting resources to support full implementation of the WHO’s policy of universal testing should be seriously considered.”

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