Modeling the Financial and Clinical Implications of Malaria Rapid Diagnostic Tests in the Case-management of Older Children and Adults in Kenya

摘要

Abstract. Using data on clinical practices for outpatients 5 years and older, test accuracy, and malaria prevalence, wenmodel financial and clinical implications of malaria rapid diagnostic tests (RDTs) under the new artemetherlumefantrinen(AL) treatment policy in one high and one low malaria prevalence district in Kenya. In the high transmissionndistrict, RDTs as actually used would improve malaria treatment (61% less over-treatment but 8% morenunder-treatment) and lower costs (21% less). Nonetheless, the majority of patients with malaria would not be correctlyntreated with AL. In the low transmission district, especially because the treatment policy was new and AL was not widelynused, RDTs as actually used would yield a minor reduction in under-treatment errors (36% less but the base is small)nwith 41% higher costs. In both districts, adherence to revised clinical practices with RDTs has the potential to furtherndecrease treatment errors with acceptable costs.