Photo by WHO/Tropical
An African child dies of malaria every
Misdiagnosis of malaria is common and the term "malaria" itself has a variety of meanings, according to one of the supplement's papers submitted by researchers from Ghana and Malawi.
Because malaria's symptoms often mimic other diseases, it is often under-diagnosed in areas where incidence is rare, they report. Conversely, in endemic areas many people diagnosed with malaria may have the indicative parasite loads, but are in fact suffering from a different disease or condition. The presence of parasites doesn't necessarily indicate disease and many people in high-transmission areas learn to tolerate parasitemia.
In the clinical setting, misdiagnosed patients may receive unnecessary medication, raising the cost of treatment and likelihood of parasite drug-resistance development. At a more global level, misdiagnosis may cause problems in clinical trials for new treatments and may interfere with the evaluation of current programs.
The authors call for a clarification of malaria's definition on two fronts. In the clinic, doctors need to identify more "signature" symptoms, such as a distinctive retinopathy, that can segregate malaria from other illnesses.
On the academic front, researchers and policy makers need to tighten their use of "malaria" to distinguish between the presence of the parasites and the actual disease, if their meaning is to be understood.