{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T16:04:05Z","timestamp":1773849845416,"version":"3.50.1"},"reference-count":55,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","license":[{"start":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T00:00:00Z","timestamp":1707264000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,7]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Acute febrile diseases transmitted by mosquitos are a diagnostic challenge for pediatricians working in sub-Saharan Africa. Misclassification due to the lack of rapid, reliable diagnostic tests leads to the overuse of antibiotics and antimalarials. Children presenting with acute fever and suspected of having malaria were examined at health care facilities in the Mwanza Region of Tanzania. The sensitivity and specificity of blood smear microscopy and malaria rapid diagnostic tests that targeted histidine-rich protein 2 and <jats:italic>Plasmodium<\/jats:italic> lactate dehydrogenase were compared with a multiplex reverse transcriptase-polymerase chain reaction (PCR)\u2013ELISA. Six hundred ninety-eight children presented with acute fever and met the criteria for inclusion; 23% received antibiotics and 23% received antimalarials prior to admission. Subsequently, 20% were confirmed by PCR to have <jats:italic>Plasmodium falciparum<\/jats:italic> infection. Blood smear microscopy exhibited 33% sensitivity and 93% specificity. The malaria rapid test provided 87% sensitivity and 98% specificity in detecting acute malaria infections. Only 7% of malaria-negative children received antimalarials at Sengerema Designated District Hospital when treatment was guided by the results of rapid testing. In contrast, 75% of malaria-negative patients were treated with antimalarial drugs at health facilities that used blood smears as the standard diagnostic test. Misclassification and premedication of nonmalarial, febrile illnesses contribute to the emergence of antimalarial and antimicrobial resistance. The incorporation of malaria rapid diagnostic tests into the clinical routine translated into improved treatment and a significant reduction in antimalarial drug prescriptions.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0254","type":"journal-article","created":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T14:16:19Z","timestamp":1703686579000},"page":"202-208","source":"Crossref","is-referenced-by-count":6,"title":["Challenges in Diagnosing and Treating Acutely Febrile Children with Suspected Malaria at Health Care Facilities in the Lake Mwanza Region of Tanzania"],"prefix":"10.4269","volume":"110","author":[{"given":"Philip","family":"Koliopoulos","sequence":"first","affiliation":[{"name":"Center of Pediatric and Adolescent Medicine, University Medical Center, Mainz, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neema","family":"Kayange","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Medicine, Bugando Medical Centre, Mwanza, Tanzania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Jensen","sequence":"additional","affiliation":[{"name":"Center of Pediatric and Adolescent Medicine, University Medical Center, Mainz, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Britta","family":"Gr\u00f6ndahl","sequence":"additional","affiliation":[{"name":"Center of Pediatric and Adolescent Medicine, University Medical Center, Mainz, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Eichmann","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Medicine, St. Joseph Hospital, Berlin, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Daniel","sequence":"additional","affiliation":[{"name":"Center of Pediatric and Adolescent Medicine, University Medical Center, Mainz, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Huth","sequence":"additional","affiliation":[{"name":"Department of Visceral and Thoracic Surgery, Klinikum Worms, Worms, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Till","family":"Eckert","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, GeoMed Kreisklinik, Gerolzhofen, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nele","family":"Klamm","sequence":"additional","affiliation":[{"name":"Center of Gynecology and Obstetrics, Augusta-Kranken-Anstalt, Bochum, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlene","family":"Follmann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gesundheits- und Pflegezentrum, R\u00fcsselsheim, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grey Carolina","family":"Medina-Monta\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Medical Center, Mainz, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adolfine","family":"Hokororo","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Medicine, Bugando Medical Centre, Mwanza, Tanzania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"Pretsch","sequence":"additional","affiliation":[{"name":"Center of Pediatric and Adolescent Medicine, University Medical Center, Mainz, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Kl\u00fcber","sequence":"additional","affiliation":[{"name":"Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Medicine, St. Vinzenz-Hospital, Dinslaken, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antke","family":"Z\u00fcchner","sequence":"additional","affiliation":[{"name":"CCBRT Maternity and Newborn Hospital, Dar es Salaam, Tanzania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marylyn M.","family":"Addo","sequence":"additional","affiliation":[{"name":"Institute for Infection Research and Vaccine Development, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Okamo","sequence":"additional","affiliation":[{"name":"Catholic University of Health and Allied Sciences, Mwanza, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen 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