[Malaria--rapid diagnostic tests and emergency self-medication].

Area of Science:

• Travel Medicine
• Infectious Diseases
• Diagnostics

Background:

• World Health Organization (WHO) recommends stand-by emergency treatment (SBT) for travelers to malaria-endemic areas.
• Malaria diagnosis based solely on clinical symptoms is unreliable, as fever has multiple causes in travelers.
• Previous studies show low utilization rates of prescribed SBT medication.

Purpose of the Study:

• To evaluate the efficacy and usability of rapid diagnostic tests (RDTs) for self-diagnosis of malaria in travelers.
• To determine if RDTs can be reliably used by travelers for stand-by emergency treatment decisions.

Main Methods:

• Review of studies on SBT utilization in European travelers.
• Analysis of studies evaluating the performance of RDTs by healthy volunteers and febrile tourists.
• Assessment of user success rates in performing and interpreting RDTs.

Main Results:

• SBT medication is prescribed to many travelers but used by a small percentage.
• While healthy volunteers showed improved RDT performance with verbal guidance, interpretation remained poor.
• Febrile tourists demonstrated low correct RDT usage and high rates of inaccurate self-diagnosis, even with confirmed malaria.

Conclusions:

• Current rapid diagnostic tests (RDTs) are not yet suitable for unsupervised self-use by travelers due to technical and interpretational challenges.
• Further technical improvements and comprehensive pre-travel training are necessary before RDTs can be recommended for traveler self-diagnosis and treatment.
• The unreliability of self-diagnosis highlights the need for accessible professional medical care for travelers in endemic regions.