Prompt and accurate diagnosis of malaria is part of effective disease management and will, if implemented effectively, help to reduce unnecessary use of antimalarials.5 High sensitivity of malaria diagnosis is important in all settings, in particular for the most vulnerable population groups, such as young children, in which the disease can be rapidly fatal. High specificity can reduce unnecessary treatment with antimalarials and improve differential diagnosis of febrile illness.
5 Further information on the diagnosis of malaria is provided in Annex 5.
The diagnosis of malaria is based on clinical criteria (clinical diagnosis) supplemented by the detection of parasites in the blood (parasitological or confirmatory diagnosis). Clinical diagnosis alone has very low specificity and in many areas parasitological diagnosis is not currently available. The decision to provide antimalarial treatment in these settings must be based on the prior probability of the illness being malaria. One needs to weigh the risk of withholding antimalarial treatment from a patient with malaria against the risk associated with antimalarial treatment when given to a patient who does not have malaria.