The implementation of preventive strategies and effective treatment has substantially reduced the incidence of malaria across many parts of Africa. The introduction of Haemophilus influenzae type b vaccine and, more recently, pneumococcal conjugate vaccine should dramatically reduce the incidence of serious bacterial infections among children. Historically, these pathogens accounted for a substantial proportion of childhood deaths in regions of Africa where malaria is endemic. High coverage with these measures will also affect the burden and spectrum of the common childhood febrile diseases. Consequently, case-management guidelines — which are currently designed to maximize sensitivity over specificity, resulting in widespread use of low-cost antimalarial or antimicrobial agents to avert adverse outcomes — will need to be revised. However, most research underpinning such guidelines was undertaken two to three decades ago. The advent of rapid diagnostic tests and molecular diagnostics has expanded the potential to identify causes of disease and may inform future management strategies for common childhood diseases. Nevertheless, few such pathogenic data are available from sub-Saharan Africa.
New Diagnostics for Common Childhood Infections