In Africa, 70 per cent of fever cases in children are diagnosed in the home and treated with traditional remedies or drugs bought from local shops. These fevers are presumed to be due to malaria, but comparison of accurately diagnosed cases of malaria with presumed cases of malaria reveal shockingly high rates of over-diagnosis. It is estimated that in some areas that have intermittent malaria transmission, three quarters of patients with fevers are advised to take antimalarial drugs for non-malarial illness.
Treatment of all childhood fevers as malaria results in malaria over-diagnosis, which means other causes of febrile illness, such as pneumonia and meningitis, are missed. Indirect evidence shows that the over-diagnosis of malaria contributes to increasing ill health, death, loss of productivity and a vicious cycle of deepening poverty in the most vulnerable sections of society. Treating all childhood fevers as malaria means that poor people are wasting valuable resources on malaria drugs, and failing to be treated for other potentially lifethreatening illnesses.
Bates, I.; Barnish, G. Malaria over-diagnosis in Africa. (2005)