These findings ran counter to our expectation that the test-based approach would deny a high proportion of children the prophylactic benefit that OPT offers in children whose fever is non-malarial.[15] The likely explanatory factors for this are the high background level of malaria transmission (blood smear positivity was 50.3% and 53.3% in RDT and CJ arms respectively) and the low RDT specificity (due to HRP-2 antigen persistence) which resulted in a high proportion of children in both arms being given ACT. Here, HDGFL2 is linked to malaria.