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Misdiagnosis of malaria comparatively higher in urban cities of Ghana

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mosquitoThere are pieces of evidence to suggest that testing for malaria is less commonly performed by health facilities in Accra and Kumasi than those elsewhere in the country, a study has shown.

This finding comes as the world commemorates this year’s World Malaria Day April 25, 2013, a day set aside to take stock of gains and losses made in malaria control efforts.

The study, contained in the Ghana Urban Malaria Study 2013 report released last week in Accra, said misdiagnosis of severe febrile illnesses could lead to fatal outcomes with other consequences of presumptive diagnosis including unnecessary expenditure, side effects from anti malarials and increased opportunity for the development of drug resistance.

The study cites, for instance, that only 11 per cent of 605 sick children presenting with fever at a hospital in Accra had malaria parasites detected by microscopy, yet 80 per cent of these children were diagnosed as having malaria.

It has shown that presumptive diagnosis of suspected malaria cases is resulting in massive misdiagnosis in the urban areas of the country.

Until now, clinical practice and national policy in the country have been informed by routine health service data suggesting that malaria is universally prevalent throughout the country. A different picture emerges however from the study that the burden of malaria is substantially lower in large cities than in surrounding rural areas.

The study, fully funded by the US President’s Malaria Initiative through the USAID, aims at helping policy makers, public health programmers and practitioners to be well informed by key findings on urban malaria.

It also shows that in large cities, neighborhoods close to urban agriculture and poorest households bear the greatest burden of malaria.

A final consequence of the prevailing practice of presumptive diagnosis is that the epidemiology of malaria is inadequately appreciated by policy makers, public health programmers and clinicians.

Some recommendations based on the findings are that for health facilities in the country’s cities, records of malaria tests should capture information about the residence of the patient and these records should be periodically analysed to identify neighborhoods with higher than average malaria burden for intervention.

Meanwhile, malaria prevalence in Ghana has dropped considerably from 86.8 per cent to 27 .5 per cent, according to Dr Constance Bart-Plange, the Manager of the National Malaria Control Programme (NMCP).

The achievement is partly attributed to the distribution of free insecticide treated nets to households throughout the country, he said.

Dr Bart-Plange indicated that a total of 11,443,69I mosquito treated nets had so far been distributed nationwide.

By Eunice Menka

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