Priorities for developing multi-disease rapid tests for acute fever in South and Southeast Asia

What is it about?

In rural South and Southeast Asia, most acute febrile illness was previously attributable to malaria but the incidence of malaria is declining. To aid diagnosis and prognosis in patients presenting with the common symptom of acute fever with no localising features but in whom malaria has been excluded, there is an urgent need to develop minimally-invasive rapid diagnostic tests (RDTs) which can test for multiple pathogen and host biomarkers. Obtaining expert consensus opinions on what biomarkers these tests should detect will contribute greatly to their development, as there is a paucity of robust epidemiological data on the diverse non-malarial causes of acute fever. We determined the biomarkers which should be included in region-specific fingerprick blood-based RDTs tailored to four patient categories differentiated by age and level of care, in the form of seven-item lists ranked in decreasing order of priority. To provide context for these rank lists, we ascertained the principal factors influencing expert priority-setting and explored perceptions of the clinical utility of such RDTs.

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Photo by Roman Wimmers on Unsplash

Photo by Roman Wimmers on Unsplash

Why is it important?

Our results provide essential region-specific guidance to aid development of RDTs for acute non-malarial fever, for which there was strong consensus for their inclusion in clinical decision-making tools for low- and semi-skilled healthcare staff.