Malaria & Fever
Management of fever (febrile illness) is a huge medical challenge. In Africa alone, over 600 million childhood fevers occur every year. Many febrile illnesses, especially in children, present with highly non-specific and overlapping signs and symptoms that are difficult to distinguish clinically. This is largely because the tools available to health professionals for diagnosing and managing childhood illnesses are limited in resource-poor settings.
In some countries – particularly in Africa – the cause of the fever is very often malaria. Malaria is ambitiously targeted for global elimination by 2030, but every year, hundreds of millions of new cases still occur, and hundreds of thousands of people die from the disease.
Diagnostics that can distinguish between the various species of malaria parasite responsible for the infection are increasingly important to guide differentiated treatment strategies, as new drugs that target specific parasites become available. They also underpin malaria elimination efforts by ensuring that both symptomatic and asymptomatic patients are identified and can be treated, and the chain of transmission broken. Diagnostic surveillance tracks disease spread, and will eventually confirm eradication.
The 2010 WHO recommendation that all patients suspected of having malaria should be tested before receiving treatment was an important step. But it also threw a spotlight on the long-overlooked challenge of what to do when the test result is negative. Prescription of a broad spectrum antibiotic is often the default course of action even though the fever may be due to a virus, in which case the antibiotic will be ineffective. Taking inappropriate drugs is not only bad for patients, it can also contribute to the development of antimicrobial resistance.
Combination tests that not only check for malaria but also differentiate between viral and bacterial infections could change the diagnostic landscape. Diagnostic tools that are flexible enough to be adapted to run tests for different pathogens according to the geographic area could also have a significant impact, alongside strong surveillance systems that can spot potential outbreaks of new pathogens.
As efforts in malaria pay off and fewer cases start to be seen, the role of diagnostics remains critical to ensure that those who do have the disease can be treated appropriately, as well as to monitor and support elimination efforts. At the same time, effective tools must be developed and deployed to identify causes of non-malarial fever, so that all patients can get the care they need.
Our approach starts with the patient, irrespective whether they may or may not have malaria. As well as supporting malaria elimination efforts, we are working with our partners and donors on diagnostic solutions that can inform optimal treatment solutions for all patients presenting with fever. Our work is therefore focused in three areas.
- R&D for improved malaria diagnostics that can detect the disease in hard-to-diagnose populations, differentiate between parasite strains to inform treatment decisions and support the introduction of targeted treatments, and support elimination strategies.
- R&D for fever diagnostics that can identify the cause of fever when it is not malaria, based on likely pathogens in specific geographic areas, and help to guide appropriate treatment and support patient care and antimicrobial stewardship.
- Addressing barriers to access and appropriate use of quality diagnostics that must be overcome to enable the use and impact of both existing and new tests, including the deployment of technological solutions to support implementation.
Malaria & Fever R&D pipeline
|Catalyse Development||Guide Use and Policy|
|Host biomarker & phenotypic ID tool landscaping||RDT for recent P. vivax infections (WEHI, Mologic)||eHealth clinical decision support toolbox||Biomarker-based product validation (multiple partners)||hsRDT in maternal & child health (multiple partners)|
|Non-HRP2 marker landscape||Bacterial vs non-bacterial triage test||Multiplexed immunoassay (Chembio)||CRP + malaria test (SD Biosensor)||CRP use in Viet Nam|
|Open-access biomarker database (Bm2Dx)||Improved RDTs for P. falciparum and P. falciparum plus P. vivax (SD/Abbott)||Fast blood culture ID|
|MAPDx platform (MSF)|
|Typhoid & other pathogen Dx landscaping|
|Simplified blood culture landscaping|
Download our full R&D pipeline.