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Randomised controlled trial
Improving malaria treatment by increasing access to accurate diagnostic tests: test results must guide treatment
  1. Michael L Wilson
  1. Denver Health/University of Colorado, Denver, Colorado, USA
  1. Correspondence to: Professor Michael L Wilson, Medical Laboratories, Mail Code #0224, Denver Health Medical Center, 777 Bannock Street, Denver, CO 80204, USA; michael.wilson{at}

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Malaria control programmes focus on two things: reducing transmission by decreasing exposure to infected mosquitoes (via residual indoor spraying, use of insecticide-treated nets and prophylactic treatment) and improving diagnosis and treatment of infected persons. Treatment should be guided by an accurate diagnosis to avoid treating persons without malaria, so as to conserve resources and delay emergence of artemesinin resistance. Diagnosis is based on microscopy as the gold standard, with use of malaria rapid diagnostic tests (MRDT) as either an adjunct or alternative to microscopy when or where microscopy is unavailable. However, treatment is frequently not based on diagnostic test results, even when diagnostic tests are available.


This was a randomised trial of MRDT in two areas of Afghanistan …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.