The online version of this article (doi:10.1186/s12936-017-2079-2) contains supplementary material, which is available to authorized users.
The WHO recommends that all suspect malaria cases be tested before receiving treatment. Rapid diagnostic tests (RDT) for malaria can be performed reliably by community health workers with no formal medical background and thus, RDTs could also be provided to travellers for self-diagnosis during visits to endemic regions.
RDTs were proposed during pre-travel consultations to pre-defined categories of travellers. A training run on their own blood was performed and, if carried out correctly, the traveller was given a written procedure on how to perform the test and act on its result. The travellers were then proposed to buy a malaria RDT kit and were interviewed upon their return.
From February 2012 to February 2017, 744 travellers were proposed RDTs and 692 performed the training run (one could not complete it due to a hand tremor). Among the 691 subjects included, 69% travelled to moderate- or low-risk areas of malaria, 18% to high-risk areas and 13% to mixed-risk areas. The two most frequent categories of travellers to whom RDTs were proposed were long-term travellers (69%) and those travelling to remote areas (57%). 543 travellers (79%) were interviewed upon return. During their trip, 17% (91/543) had a medical problem with fever and 12% (65/543) without fever. Among 91 febrile patients, 57% (52/91) performed an RDT, 22% (20/91) consulted immediately without using the test, and 21% (19/91) did neither. Four RDTs (4/52; 8%) were positive: 2 in low-risk and 2 in high-risk areas (0.7% attack rate of self-documented malaria). Two travellers could not perform the test correctly and attended a facility or took standby emergency treatment. Four travellers with negative results repeated the test after 24 h; all were still negative. Carrying RDTs made travellers feel more secure, especially when travelling with children.
1/6 travellers experienced fever and 4/5 of those reacted appropriately: more than half used RDTs and a quarter consulted immediately. Four travellers (including 2 from low-risk areas) diagnosed themselves with malaria and self-treated successfully. This strategy allows prompt treatment for malaria in high-risk groups and may avoid over-diagnosis (and subsequent inappropriate treatment) of malaria on-site.
Additional file 1. Illustrated instruction leaflet.
WHO. Global Malaria Programme. World malaria report, 2014. Geneva: World Health Organization; 2014.
Genton B, D’Acremont V. Malaria prevention in travelers. Infect Dis Clin N Am. 2012;26:637–54. CrossRef
Centre de Médecine des Voyages de l’Institut de Médecine Sociale et Préventive de l’Université de Zürich. Vaccinations et Mesures Antipaludiques, Recommandations. État Mars 2014. Office Fédéral de la Santé Publique. 2014;13:233–55.
Patel D. Occupational travel. Occup Med. 2011;61:6–18. CrossRef
WHO. Malaria rapid diagnostic test performance. Results of WHO product testing of malaria MRDTs: round 5. Geneva: World Health Organization; 2013.
Nothdurft HD, Jelinek T, Pechel SM, Hess F, Maiwald H, Marschang A, et al. Stand-by treatment of suspected malaria in travellers. Trop Med Parasitol. 1995;46:161–3. PubMed
Behrens RH. Standby emergency treatment of malaria for travellers to low transmission destinations. Does it make sense or save lives? J Travel Med. 2017;24. doi: 10.1093/jtm/tax034.
Genton B, D’Acremont V. Standby emergency treatment of malaria in travellers (SBET): so be eager to test. J Travel Med. 2017;24. doi: 10.1093/jtm/tax032.
PHE publications gateway number 2016170. Malaria imported into the UK 2015: implications for those advising travellers. 2016.
- Self-diagnosis of malaria by travellers: a cohort study on the use of malaria rapid diagnostic tests provided by a Swiss travel clinic
- BioMed Central
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