@article{fdi:010070139,
  title = {{M}alaria overdiagnosis and subsequent overconsumption of antimalarial drugs in {A}ngola : consequences and effects on human health},
  author = {{M}anguin, {S}ylvie and {F}oumane, {V}. and {B}esnard, {P}. and {F}ortes, {F}. and {C}arnevale, {P}ierre},
  editor = {},
  language = {{ENG}},
  abstract = {{M}icroscopic blood smear examinations done in health centers of {A}ngola demonstrated a large overdiagnosis of malaria cases with an average rate of errors as high as 85%. {O}verall 83% of patients who received {C}oartem® had an inappropriate treatment. {O}verestimated malaria diagnosis was noticed even when specific symptoms were part of the clinical observation, antimalarial treatments being subsequently given. {T}hen, malaria overdiagnosis has three main consequences, (i) the lack of data reliability is of great concern, impeding epidemiological records and evaluation of the actual influence of operations as scheduled by the {N}ational {M}alaria {C}ontrol {P}rogramme; (ii) the large misuse of antimalarial drug can increase the selective pressure for resistant strain and can make a false consideration of drug resistant {P}. falciparum crisis; and (iii) the need of strengthening national health centers in term of human, with training in microscopy, and equipment resources to improve malaria diagnosis with a large scale use of rapid diagnostic tests associated with thick blood smears, backed up by a “quality control” developed by the national health authorities. {M}onitoring of malaria cases was done in three {A}ngolan health centers of {A}lto {L}iro ({L}obito town) and neighbor villages of {C}ambambi and {A}sseque ({B}engu{\'e}la {P}rovince) to evaluate the real burden of malaria. {C}arriers of {P}lasmodium among patients of newly-borne to 14 years old, with or without fever, were analyzed and compared to presumptive malaria cases diagnosed in these health centers. {P}resumptive malaria cases were diagnosed six times more than the positive thick blood smears done on the same children. {I}n {A}lto {L}iro health center, the percentage of diagnosis error reached 98%, while in {C}ambambi and {A}sseque it was of 79% and 78% respectively. {T}he percentage of confirmed malaria cases was significantly higher during the dry (20.2%) than the rainy (13.2%) season. {T}hese observations in three peripheral health centers confirmed what has already been noticed in other malaria endemic regions, and highlight the need for an accurate evaluation of the {M}alaria control programme implemented in {A}ngola.},
  keywords = {{PALUDISME} ; {EPIDEMIOLOGIE} ; {DIAGNOSTIC} ; {TRAITEMENT} {MEDICAL} ; {ETUDE} {DE} {CAS} ; {ANGOLA}},
  booktitle = {},
  journal = {{A}cta {T}ropica},
  volume = {171},
  numero = {},
  pages = {58--63},
  ISSN = {0001-706{X}},
  year = {2017},
  DOI = {10.1016/j.actatropica.2017.03.022},
  URL = {https://www.documentation.ird.fr/hor/fdi:010070139},
}