End‐user errors in applying two malaria rapid diagnostic tests in a remote area of Sudan

Seidahmed, Osama M.E.; Mohamedein, Muneir M.N.; Elsir, Afrah Awad; Ali, Fayez T.; Malik, El Fatih M.; Ahmed, E. S.

doi:10.1111/j.1365-3156.2008.02015.x

Cited by 42 publications

(29 citation statements)

References 9 publications

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“…Test lines, even faint, should be interpreted as positive [13]. Other previously reported errors were the interpretation of invalid tests [2], [4], [14] and lacking or incorrect species identification in a three-band test [2]. About one in ten participants interpreted negative RDTs as positive, which is lower than in EQAs for malaria microscopy [15], [16].…”

Section: Discussionmentioning

confidence: 99%

External Quality Assessment of Reading and Interpretation of Malaria Rapid Diagnostic Tests among 1849 End-Users in the Democratic Republic of the Congo through Short Message Service (SMS)

et al. 2013

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BackgroundAlthough malaria rapid diagnostic tests (RDT) are simple to perform, they remain subject to errors, mainly related to the post-analytical phase. We organized the first large scale SMS based external quality assessment (EQA) on correct reading and interpretation of photographs of a three-band malaria RDT among laboratory health workers in the Democratic Republic of the Congo (DR Congo).Methods and FindingsHigh resolution EQA photographs of 10 RDT results together with a questionnaire were distributed to health facilities in 9 out of 11 provinces in DR Congo. Each laboratory health worker answered the EQA by Short Message Service (SMS). Filled-in questionnaires from each health facility were sent back to Kinshasa. A total of 1849 laboratory health workers in 1014 health facilities participated. Most frequent errors in RDT reading were i) failure to recognize invalid (13.2–32.5% ) or negative test results (9.8–12.8%), (ii) overlooking faint test lines (4.1–31.2%) and (iii) incorrect identification of the malaria species (12.1–17.4%). No uniform strategy for diagnosis of malaria at the health facility was present. Stock outs of RDTs occurred frequently. Half of the health facilities had not received an RDT training. Only two thirds used the RDT recommended by the National Malaria Control Program. Performance of RDT reading was positively associated with training and the technical level of health facility. Facilities with RDT positivity rates >50% and located in Eastern DR Congo performed worse.ConclusionsOur study confirmed that errors in reading and interpretation of malaria RDTs are widespread and highlighted the problem of stock outs of RDTs. Adequate training of end-users in the application of malaria RDTs associated with regular EQAs is recommended.

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Section: Discussionmentioning

confidence: 99%

External Quality Assessment of Reading and Interpretation of Malaria Rapid Diagnostic Tests among 1849 End-Users in the Democratic Republic of the Congo through Short Message Service (SMS)

et al. 2013

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“…Treatment of P. falciparum with artemisinin combination therapies (ACT) alone will hinder the development of clinical malaria and can kill immature gametocytes, reducing the probability of onward transmission to mosquitoes [44]–[46], but it may not be sufficient to prevent transmission shortly after treatment [47]. Integrating a treatment drug that acts against mature gametocytes, such as an 8-aminoquinoline, has the potential to further reduce transmission [48],[49].…”

Section: Considerations For Successful Acd Implementationmentioning

confidence: 99%

“…Detecting sub-patent infections requires sensitive molecular diagnostic methods, such as polymerase chain reaction (PCR) or loop-attenuated isothermal amplification (LAMP) [46],[63],[65]. At present, the use of PCR and LAMP for ACD is impractical because of their cost, infrastructure requirements, and long turn-around times.…”

Section: Screening Test Sensitivity and Mass Drug Administrationmentioning

confidence: 99%

Targeting Asymptomatic Malaria Infections: Active Surveillance in Control and Elimination

et al. 2013

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“…The simplicity of the RDT procedure has also avoided many errors of manipulation or interpretation. The few difficulties encountered by the CHWs were mainly related to the amount of blood drawn at the finger (especially for very young children) or the reading and interpretation of the results of certain tests, as has been previously noted by Seidahmed et al [26]. …”

Section: Discussionmentioning

confidence: 88%

Management of uncomplicated malaria in febrile under five-year-old children by community health workers in Madagascar: reliability of malaria rapid diagnostic tests

Ratsimbasoa

Ravony

Vonimpaisomihanta

et al. 2012

Malar J

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BackgroundEarly diagnosis, as well as prompt and effective treatment of uncomplicated malaria, are essential components of the anti-malaria strategy in Madagascar to prevent severe malaria, reduce mortality and limit malaria transmission. The purpose of this study was to assess the performance of the malaria rapid diagnostic tests (RDTs) used by community health workers (CHWs) by comparing RDT results with two reference methods (microscopy and Polymerase Chain Reaction, PCR).MethodsEight CHWs in two districts, each with a different level of endemic malaria transmission, were trained to use RDTs in the management of febrile children under five years of age. RDTs were performed by CHWs in all febrile children who consulted for fever. In parallel, retrospective parasitological diagnoses were made by microscopy and PCR. The results of these different diagnostic methods were analysed to evaluate the diagnostic performance of the RDTs administered by the CHWs. The stability of the RDTs stored by CHWs was also evaluated.ResultsAmong 190 febrile children with suspected malaria who visited CHWs between February 2009 and February 2010, 89.5% were found to be positive for malaria parasites by PCR, 51.6% were positive by microscopy and 55.8% were positive by RDT. The performance accuracy of the RDTs used by CHWs in terms of sensitivity, specificity, positive and negative predictive values was greater than 85%. Concordance between microscopy and RDT, estimated by the Kappa value was 0.83 (95% CI: 0.75-0.91). RDTs stored by CHWs for 24 months were capable of detecting Plasmodium falciparum in blood at a level of 200 parasites/μl.ConclusionIntroduction of easy-to-use diagnostic tools, such as RDTs, at the community level appears to be an effective strategy for improving febrile patient management and for reducing excessive use of anti-malarial drugs.

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End‐user errors in applying two malaria rapid diagnostic tests in a remote area of Sudan

Cited by 42 publications

References 9 publications

External Quality Assessment of Reading and Interpretation of Malaria Rapid Diagnostic Tests among 1849 End-Users in the Democratic Republic of the Congo through Short Message Service (SMS)

External Quality Assessment of Reading and Interpretation of Malaria Rapid Diagnostic Tests among 1849 End-Users in the Democratic Republic of the Congo through Short Message Service (SMS)

Targeting Asymptomatic Malaria Infections: Active Surveillance in Control and Elimination

Management of uncomplicated malaria in febrile under five-year-old children by community health workers in Madagascar: reliability of malaria rapid diagnostic tests

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