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Targeting

During the lifetime of the ACT Consortium, wherever overdiagnosis was looked for in Africa, it was found. In most settings, a substantial proportion of those treated for malaria did not have any parasites, and in many low-transmission settings and in adults it could be the great majority (over 75%).

 

ACT Now For a Malaria Free World from ACT Consortium on Vimeo.

 

As of July 2016, some cross-cutting analysis was still being finalised. Please search for ACT Consortium or the relevant authors in the scientific literature or contact Dr Heidi Hopkins at the London School of Hygiene & Tropical Medicine for updates on post ACT Consortium work: heidi.hopkins [at] lshtm.ac.uk.

 

Read about our work on cost-effectiveness and in the private health care sector

Learn about our projects and resources on improving the targeting of ACTs or download a summary of our research findings.

 

Diagnosis: key to malaria control from ACT Consortium on Vimeo.

 

Research addressed by the consortium

  • Will the deployment of RDTs lead to an improvement in case identification and rational prescription of antimalarials and antibiotics at an individual level where microscopy already exists, but is ignored? This needs to be addressed in settings with different transmission intensities and healthcare systems, and can be addressed using relatively simple individually-randomised trials.
  • Will the deployment of RDTs lead to an improvement in case identification and rational prescription of antimalarials and antibiotics at an individual level where microscopy does not exist and diagnosis is currently syndromic (eg most dispensaries)? 
  • Does using RDTs to limit prescriptions of antimalarials have a positive or negative impact on morbidity, both malaria-specific (such as anaemia) and from other causes of febrile illness (eg bacterial diseases) at the population level?  This will need to be addressed using cluster randomised trials.
  • Can rational prescribing of antimalarials be improved by behavioural interventions targeting both patients and healthcare workers? This will need to be addressed using cluster randomised trials.
  • What is the impact of RDTs on prescribing rationally for falciparum malaria in settings where vivax malaria is the predominant species?  This is a major problem in much of South Asia and parts of the Horn of Africa.
  • How cost-effective are these diagnostic interventions?