'As a clinician, you are not managing lab results, you are managing the patient': How the enactment of malaria at health facilities in Cameroon compares with new WHO guidelines for the use of malaria tests

► Health workers overused antimalarial drugs to meet perceived psychological, economical and wider social needs. ► Malaria tests also served these wider functions, with little emphasis made on their role as indicators of parasitaemia. ► These priorities conflict with the expected role of tests as solely diagnostic tools, as implicit in WHO guidelines. ► Broader functions of medical consultations beyond the pathophysiological require recognition in policy and programme design.