Antimicrobial resistance (AMR) is an increasingly critical public health problem and global health security threat. New diagnostic tools that support integrated approaches to fever management can play a role in averting a “post-antibiotic era” where treatments for common infections are no longer effective.
Pneumonia (24%), diarrhoea (15%), and malaria (9%), the leading causes of death in children, are all treatable. Both pneumonia and malaria are febrile illnesses, and common causes of diarrhoea in children (e.g. rotavirus, Escherichia coli) can also include fever. However, the effectiveness of key medicines to treat these illnesses are at risk i.e. resistance to artemisinin-based combination therapies is spreading in South-East Asia and antibiotic resistance is a growing global concern. Efforts to improve child survival and preserve essential medicines threatened by resistance require a more effective, integrated response to childhood fever.
Over three-quarters of children seeking care at facilities and in the community in low- and middle- income countries present with fever, but only a fraction of children with fever require a specific treatment. Many children are unnecessarily put on treatment, increasing the risk of resistance and causing drugs to go to waste. In particular, once malaria has been ruled out, misdiagnosis of fever is common and approximately 69% of people who test negative for malaria receive antibiotics, even without confirming the need of an antibiotic.
Better diagnostics tools for integrated fever management are therefore key to ensuring that children get the right treatment at the right time, while improving child survival and fostering antibiotic stewardship. But effective, affordable tools adapted for use in LMICs including diagnostics for non-malaria fever, are limited and accelerated investments are needed. This discussion will explore the potential of new tools on the horizon as well as the challenges of scaling tools for an integrated response to fever management.