Fever Case Management Treatment Algorithm


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In malaria endemic countries, approximately 40% of the population seek care and treatment for febrile illnesses in the private sector. Successful malaria control, therefore, greatly depends on effective diagnosis and treatment within private sector outlets.

Treatment algorithms are simple decision trees that consist of a series of questions that can be easily answered by a “yes” or “no”. They provide step-by-step guidance for diagnosis, treatment or referral of customers presenting with febrile illness. Algorithms are needed to ensure that all private providers manage fever cases correctly. Algorithms also help providers identify patients who should be referred without getting tested (patients with danger signs, pregnant women in the first trimester of pregnancy, or children under two months) and determine what to do in the case of a positive or negative Rapid Diagnostic Test (RDT) result.

Given that the level of education and medical expertise of private providers will likely vary, two types of Fever Case Management (FCM) algorithms are available:

  1. One addressed to physicians or other health professionals qualified to conduct differential diagnosis. In the case of negative RDT results, the algorithm expands on how to investigate other causes of fever (i.e. pneumonia and diarrhea) and it is mainly built on the integrated case management (ICM) algorithm;
  2. One addressed to health workers who don’t have the level of education required to conduct differential diagnosis of malaria. It focuses on how to test fever cases for malaria and in case of negative RDT results, providers are advised to refer patients to a referral unit to investigate other causes of fever.

These Fever Case Management (FCM) treatment algorithms are part of a larger Quality Assurance Manual and Toolkit developed through the UNITAID Private Sector RDT project to provide guidance on quality assurance for FCM in the private sector.