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Revolutionary Malaria Tests Have Unexpected Downsides
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8 Aug 2017 03:38 PM EST

A simple fix to a major public health challenge has turned out to be not so simple after all. In the early 2000s, researchers developed rapid diagnostic tests for malaria, a major childhood killer. Simple as a home pregnancy kit, these tests need just one drop of blood from a finger prick to detect the malaria parasite. They enabled health workers in remote villages in Africa and Asia to accurately and almost instantly diagnose malaria, making them less likely to overuse the new generation of “wonder drugs,” which were in danger of being lost to drug resistance. But now the largest analysis of rapid test use yet, in poor settings in Africa and South Asia, suggests that along with its enormous benefits, the roll-out had unintended—and undesirable—effects. Where the tests were used, the number of "wonder drug" prescriptions dropped, as hoped. But antibiotic prescriptions surged; at most study sites, 40% to 80% of patients walked away with the drugs, considerably more than needed them. Such overuse could contribute to the global rise in antibiotic-resistant infections; it’s a classic example of when fixing one problem exacerbates another.

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