Preliminary enquiry into the availability, price and quality of malaria rapid diagnostic tests in the private health sector of six malaria‐endemic countries

Abstract

Abstractobjectives This enquiry aimed to provide a snap-shot of availability, price and quality of malaria rapid diagnostic tests (RDTs) in private health facilities at selected sites in six malaria-endemic countries in Africa, South East Asia and South America.methods In each study site, data collectors surveyed private healthcare facilities which were selected based on accessibility from their home institution. Using a questionnaire, information was recorded about the facility itself and the malaria RDT(s) available. Where possible, a small number of RDTs were procured and quality control tested using a standardized procedure.results Of the 324 private healthcare facilities visited, 35 outlets (mainly private clinics and hospitals) were found to supply 10 different types of RDTs products. RDT prices across the six countries ranged from US$1.00 to $16.81. Five of the 14 malaria RDTs collected failed quality control testing.conclusions In the private outlets sampled, the availability of RDTs was limited. Some of the RDTs whose quality we tested demonstrated inadequate sensitivity. This presents a number of risks. Given the more widespread distribution of antimalarials currently planned for private sector facilities, parasitebased diagnosis in this sector will be essential to adhere to the WHO guidelines for effective case management of malaria. Considerable regulation and quality control are also necessary to assure the availability of accurate and reliable RDTs, as well as adequate case management and provider adherence to RDT results. Public sector engagement is likely to be essential in this process.

Global survey of malaria rapid diagnostic test (RDT) sales, procurement and lot verification practices: assessing the use of the WHO–FIND Malaria RDT Evaluation Programme (2011–2014)

“…According to a manufacturer-specific market analysis conducted with the survey data (not disclosed here), private sector seems to attract a higher number of small/medium manufacturers, and especially those delivering products that do not comply or have not been submitted to PT evaluations. This is consistent with poor performance results reported from a small-scale study in 2009 among six malaria-endemic countries [20], and most probably due to the lack of regulation and/or less control of diagnostic products being used in the private health care sector in most malaria-endemic countries. A larger, multi-country survey conducted in 2011 [28] also documented that the overall number of products within the private sector was proportionally higher than in the public sector, thus supporting the finding of more diversified product assortment in the retail sector reported here.…”

“…In addition, there is a critical knowledge gap around sales of RDTs in the private health care sector, where 40–60% of people seek care for febrile illnesses in some endemic countries [19]. A snap-shot of RDT availability and quality in private health care outlets of six countries was published by Albertini et al [20]. However complete and reliable data on overall procurement practices and RDT performance in this sector are not available.…”

Testing times: trends in availability, price, and market share of malaria diagnostics in the public and private healthcare sector across eight sub-Saharan African countries from 2009 to 2015

“…However, this information has to date not been available. Most studies that evaluate accessibility to malaria diagnostic testing tend to be small in scale, not nationally representative, focus on either the public or private sector only, or observe only one time point [11–15]. A more recent multi-country ACTwatch assessment of malaria diagnostic testing availability across the public and private sectors, published in 2015, focused solely on RDT availability in eight SSA countries during 2011 [16].…”

Engaging the private sector in malaria surveillance: a review of strategies and recommendations for elimination settings

“…Formal private providers have some formal training, accreditation or licensure [48]. The formal for-profit private sector consists of private hospitals and clinics, pharmacies, registered or accredited drug dispensaries and large corporations and companies that provide their own medical services and private diagnostic facilities.…”