Evaluation of the interpretation and reporting of malaria rapid diagnostic test results

The Global Technical Strategy for Malaria 2016-2030 (GTS) upgraded surveillance (the collection, analysis and use of malaria data to plan, implement and evaluate programs) to a core intervention within national malaria strategies. While the elevation of surveillance as an intervention has corresponded with improvements in malaria surveillance, continued attention is needed to ensure that the information collected through routine surveillance systems is of sufficient quality to be useful in identifying areas and population groups that are most affected by malaria, planning interventions and monitoring progress over time in controlling and eliminating malaria. The accuracy of surveillance for malaria depends on the correct administration, interpretation, adherence, recording and reporting of RDT results where RDTs are the predominant parasitological test. For case management, there is the additional consideration of HCW adherence to RDT results. Despite the accuracy and quality of RDTs and their expanding use in SSA, there remain persistent concerns over HCWs’ ability to correctly implement and interpret RDT results, the adherence of prescription practices to the results, and the fidelity of the recording and reporting of RDT results within the HMIS.

PMI Insights is conducting operations research in Benin, Cote d’Ivoire, Nigeria, and Uganda to measure the degree of agreement between RDT results as recorded in health facility registers and results determined by an independent, objective panel that will independently review high-quality photographs of the RDTs taken through a phone-based application. The study also seeks to identify factors at the level of the individual patient, healthcare worker, facility, transmission season and transmission setting that affect the type of agreement or disagreement between healthcare worker and panel RDT results. The study, led by local research partners in each of the four focus countries (listed below), will include a six-month observational study in peripheral health facilities; a knowledge, attitudes, practices, and behaviors (KAPB) survey with healthcare workers; and in-depth interviews with healthcare workers to further explore the factors that contribute to RDT administration and reporting practices. Results from the study will be available in June 2024.

Purpose: Understand the degree of agreement between RDT results reported by healthcare workers and an independent, objective panel of reviewers, as well as the potential factors influencing the level of agreement or disagreement.

Study team: PATH, Centre de Recherche Entomologique de Cotonou (Benin), Institut National de Santé Publique (Cote d’Ivoire), Sydani Group (Nigeria), Makere University (Uganda)

Timeline: December 2022 – June 2024