Simple Measures Could Improve Malaria Diagnostic Kits

Published on the SciDev.Net website, this article discusses the effectiveness of rapid diagnostic tests (RDTs) for malaria, drawing on three papers that share the findings of studies assessing RDTs in practice. The article outlines how studies suggest that the effectiveness of RDTs could be greatly improved by a few simple measures, including providing better information for health workers on how to use them in the field, how to spot common errors, and providing clearer and more complete information on and in the packages.

The article mentions that a review of the tests, published on July 6 by the global non-governmental organisation The Cochrane Collaboration, found the tests to be "very accurate" when compared with laboratory-based microscopy or polymerase chain reaction tests. However, according to Piero Olliaro, a co-author of the review who works on the Special Programme for Research and Training in Tropical Diseases at the World Health Organisation, such reviews may overlook problems faced by health workers in real-life settings.

Based on analysis of the accuracy of 873 tests from a Mozambique hospital, researchers found a range of problems, including false-negative results in patients with high parasite densities because the display was too faint to see. Meanwhile, where health workers replaced the buffer (a liquid solution needed to run the tests) with water or buffer from another kit, three-quarters of tests gave false-positive results. The study recommends providing better information about these limitations, providing more than one buffer in the kit, and including a warning in information leaflets.

The article also mentiones that an earlier study published in the Malaria Journal in February 2011 concluded that, overall, malaria RDTs packages showed shortcomings in quality of construction, design and labelling of boxes, device packages, and devices and buffers. Information inserts were difficult to read and lacked relevant information. The study was prompted when, during field visits in Africa, teams of the Institute of Tropical Medicine (ITM) occasionally noted shortcomings in RDT kit boxes, content, and instructions.

The study recommended that end-users and manufactures should reach consensus on uniform codes for labelling. The conclusion also notes that generic recommendations about how to layout and appropriately design information inserts, as well as use of figures, can be found guidelines issued by the WHO. Readability, cultural, and linguistic backgrounds should be taken into account, and all texts and figures should be assessed for appropriateness and comprehension among the targeted end-users.