The role of the Deki Reader™ in malaria diagnosis, treatment and reporting: findings from an Africare pilot project in Nigeria

Adah, Patrick; Maduka, Omosivie; Obasi, Obinna; Doherty, Orode; Oguntoye, Susana; Seadon, Kayla; Jalon, Oren; Zwingerman, Nora; Uhomoibhi, Perpetua

doi:10.1186/s12936-018-2356-8

Cited by 9 publications

(7 citation statements)

References 13 publications

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“…The Fionet system uses a device called Deki Reader™ which combines standard mobile devices with custom software to gather demographic patient data, provide guidance to health care workers on conducting testing, taking pictures of completed RDT assays, transmits data over commercially available cell phone services. It also contains a web portal for uploading processed RDT images, transmission of patient demographic information, and remote storage and access of the data [25–29]. This mobile health technology platform has been successfully used in small programs for quality assurance and quality improvement of malaria diagnosis by community health workers in Kenya [24].…”

Section: Introductionmentioning

confidence: 99%

The use of Fionet technology for external quality control of malaria rapid diagnostic tests and monitoring health workers’ performance in rural military health facilities in Tanzania

et al. 2018

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IntroductionInternal and external quality control (QC) of rapid diagnostic tests (RDTs) is important to increase reliability of RDTs currently used to diagnose malaria. However, cross-checking of used RDTs as part of quality assurance can rarely be done by off-site personnel because there is no guarantee of retaining visible test lines after manufacturers’ recommended reading time. Therefore, this study examined the potential of using Fionet™ technology for remote RDT quality monitoring at seven clinics, identifying reasons for making RDT processing and interpretation errors, and taking corrective actions for improvement of diagnosis and consequently improved management of febrile patientsMethodsThe study was conducted at seven military health facilities in Mainland Tanzania and utilized RDTs capable of detecting Plasmodium falciparum specific Histidine-rich protein 2 (Pf-HRP2) and the genus specific Plasmodium lactate dehydrogenase (pLDH) for other species of plasmodium (P. vivax, P. malariae or P. ovale; pan-pLDH). Patients’ data and images of processed RDTs from seven clinics were uploaded on a Fionet web portal and reviewed regularly to monitor preparation procedures and visual interpretation of test results compared to automated analysis using the Deki reader of RDT. Problems detected were rapidly communicated to remote laboratory personnel at the clinic for corrective action and follow-up of patients who were falsely diagnosed as negative and missed treatment. Factors contributing to making errors in visual interpretation of RDT results were analyzed during visits to the health facilities.ResultsA total of 1,367 (1.6%) out of 83,294 RDT test images uploaded to the Fionet portal had discordant test results of which 822 (60.1%) and 545 (39.9%) were falsely reported as negative and positive, respectively. False negative and false positive test results were common for a single test line in 515 (62.7%) and 741 (54.2%) tests, respectively. Out of 1,367 RDT images assessed, 98 (7.2%) had quality problems related to preparation procedures of which 95(96.9%) errors were due to putting too much blood on the sample well or insufficient buffer in the respective wells. The reasons for discrepant results included, false reporting of none existent lines in 526 (38.5%) tests, missing a faint positive line in 493 (36.1%), missing a strong positive line in 248(18.1%) and errors caused by poorly processed RDTs in 96 (7.2%) tests. Among the false negative tests (n = 822), 669 (48.9%) patients were eligible for follow–up and only 339 (48.5%) were reached and 291 (85.8%) received appropriate anti-malaria therapy.ConclusionFionet technology enabled remote monitoring of RDT quality issues, identifying reasons contributing to laboratory personnel making errors and provided a rapid method to implement corrective actions at remote sites to improve malaria diagnosis and consequently improved health care management of febrile patients infected with malaria.

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Section: Introductionmentioning

confidence: 99%

The use of Fionet technology for external quality control of malaria rapid diagnostic tests and monitoring health workers’ performance in rural military health facilities in Tanzania

et al. 2018

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“…Technology such as ScanForm, 12 which allows health facility staff to take and upload photographs of the register with automatic conversion to database structure, has been successfully piloted subnationally, but it requires production and distribution of specialized registers and might not be a scalable approach for all countries. There are also examples of using automated RDT readers to directly report test results into a central database 13 , 14 that can be linked to DHIS2; however, the scale-up of this costly technology has proven to be challenging.…”

Section: Resultsmentioning

confidence: 99%

Surveillance as a Core Intervention to Strengthen Malaria Control Programs in Moderate to High Transmission Settings

Fountain

Yé

Roca-Feltrer

et al. 2023

The American Journal of Tropical Medicine and Hygiene

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New tools are needed for malaria control, and recent improvements in malaria surveillance have opened the possibility of transforming surveillance into a core intervention. Implementing this strategy can be challenging in moderate to high transmission settings. However, there is a wealth of practical experience among national malaria control programs and partners working to improve and use malaria surveillance data to guide programming. Granular and timely data are critical to understanding geographic heterogeneity, appropriately defining and targeting interventions packages, and enabling timely decision-making at the operational level. Resources to be targeted based on surveillance data include vector control, case management commodities, outbreak responses, quality improvement interventions, and human resources, including community health workers, as they contribute to a more refined granularity of the surveillance system. Effectively transforming malaria surveillance into a core intervention will require strong global and national leadership, empowerment of subnational and local leaders, collaboration among development partners, and global coordination. Ensuring that national health systems include community health work can contribute to a successful transformation. It will require a strong supply chain to ensure that all suspected cases can be diagnosed and data reporting tools including appropriate electronic devices to provide timely data. Regular data quality audits, decentralized implementation, supportive supervision, data-informed decision-making processes, and harnessing technology for data analysis and visualization are needed to improve the capacity for data-driven decision-making at all levels. Finally, resources must be available to respond programmatically to these decisions.

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“…Therefore, ensuring the accurate diagnosis will facilitate early detection and effective standard treatment for malaria cases. There are usually three methods to diagnose malaria: microscopic examination of Giemsa-stained thick and thin blood smears, RDTs and PCR ( 23 , 24 ). In general, microscopic examination was considered the gold standard for immediate diagnosis ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

Analysis of Epidemiological Changes and Prevention Effects for Malaria in Weifang, Shandong Province, China from 1957 to 2017

Song

Shi

Zhang

et al. 2020

ijph

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Background: We aimed to conduct a retrospective analysis of the epidemiological changes and prevention effects for malaria in Weifang, Shandong Peninsula, China from 1957 to 2017. Methods: The malaria data from a web-based reporting system were analyzed to explore malaria epidemiological characteristics and prevention effects in Weifang. Results: Overall, 1, 704, 890 malaria cases were reported in Weifang from 1957 to 2017, of which two major malaria epidemics occurred in 1961 (827.28/10, 000) and 1971 (366.14/10, 000). Prior to 1997, all malaria patients (1, 704, 829) were infected with Plasmodium vivax (P. vivax). After 2007, the cases of Plasmodium falciparum (P. falciparum) showed an upward trend (76.8%). The reported cases after the 21st century were mainly imported cases, and the last indigenous case was a patient that infected with P. vivax in 2006. Overall, 36 imported cases were reported from 2010 to 2017, of which 88.9% were acquired in Africa. Except for one 32-year-old woman, the rest were male (97.2%), in which laborers and farmers represented the vast majority (66.6%). From 1987 to 2017, there were 1, 224, 474 cases of fever with blood tests, and the average blood test rate was 4.9%. From 1957 to 2017, a total of 1, 704, 890 malaria patients were treated, 96 cases were treated during resting phase from 1987 to 2017. Conclusion: Weifang should continue to strengthen the management of the migrant population, making blood tests for fever patients and patient treatment as important means of malaria control and monitoring.

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The role of the Deki Reader™ in malaria diagnosis, treatment and reporting: findings from an Africare pilot project in Nigeria

Cited by 9 publications

References 13 publications

The use of Fionet technology for external quality control of malaria rapid diagnostic tests and monitoring health workers’ performance in rural military health facilities in Tanzania

The use of Fionet technology for external quality control of malaria rapid diagnostic tests and monitoring health workers’ performance in rural military health facilities in Tanzania

Surveillance as a Core Intervention to Strengthen Malaria Control Programs in Moderate to High Transmission Settings

Analysis of Epidemiological Changes and Prevention Effects for Malaria in Weifang, Shandong Province, China from 1957 to 2017

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