Task-shifting in Malaria management: The emerging role of nurses in rural Madagascar – case report and mini-review
DOI:
https://doi.org/10.12923/pielxxiw-2026-0030Keywords:
malaria, Plasmodium falciparum, Task shifting, Nurse-led management, Rapid diagnostic tests (RDTs)Abstract
Aim. The case presentation illustrating the role of nurses in malaria management in rural Madagascar and to discuss the implications of task shifting in low-resource settings.
Material and methods. The present study analyzed the case of a 67-year-old woman with severe Plasmodium falciparum malaria, alongside a concise narrative review (2007-2025) on nurse-led malaria diagnosis and treatment. The patient was managed by trained nurses, who followed the national and WHO malaria guidelines.
Results. The patient received intravenous artesunate (2.4 mg/kg at 0, 12, 24 h, then daily) and supportive therapy. Blood transfusion was withheld due to stability and limited supply. The patient improved and was discharged on the second day. Literature review confirmed that nurses and community health workers safely conduct RDT-based diagnosis and deliver ACTs when supported by supervision, training and supply chains, though challenges remain with RDT quality and stock-outs.
Conclusions. Nurse-led malaria management is feasible and effective in resource-limited rural contexts. Task shifting can improve access and timeliness of care, provided that quality assurance, supervision and clear referral criteria are maintained.
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