Comparing Decisions for Malaria Testing and Presumptive Treatment: A Net Health Benefit Analysis

Background. Rapid tests for malaria are being distributed through vendors to individual patients, presenting the dilemma of determining how individuals are incentivized to pursue testing for malaria, versus the traditional approach of presumptively treating fevers with antimalar-ial drugs. Methods and Findings. We incorporated testing and treatment data from 6 African countries into a dynamic model of malaria transmission and nonmalar-ial causes of fever to investigate how variations in the epi-demiologic risk of malaria and the prices of rapid diagnostic tests (RDTs) and treatments affect testing and treatment choices from the perspective of febrile patients, public health officials, and drug shop owners. In environ-ments falling below a critical threshold infection rate (entomological inoculation rate) of 282 for patients olde