Community Health Workers Use Malaria Rapid Diagnostic Tests (RDTs) Safely and Accurately: Results of a Longitudinal Study in Zambia

Malaria Consortium, Maputo, Mozambique; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Malaria Consortium, Lusaka, Zambia; Zambia National Malaria Control Center, Lusaka, Zambia; Livingstone District Health Management Team, Livingstone, Zambia; World Health Organization, Lusaka, Zambia; Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
The American journal of tropical medicine and hygiene (Impact Factor: 2.74). 07/2012; 87(1):57-63. DOI: 10.4269/ajtmh.2012.11-0800
Source: PubMed

ABSTRACT Malaria rapid diagnostic tests (RDTs) could radically improve febrile illness management in remote and low-resource populations. However, reliance upon community health workers (CHWs) remains controversial because of concerns about blood safety and appropriate use of artemisinin combination therapy. This study assessed CHW ability to use RDTs safely and accurately up to 12 months post-training. We trained 65 Zambian CHWs, and then provided RDTs, job-aids, and other necessary supplies for village use. Observers assessed CHW performance at 3, 6, and 12 months post-training. Critical steps performed correctly increased from 87.5% at 3 months to 100% subsequently. However, a few CHWs incorrectly read faint positive or invalid results as negative. Although most indicators improved or remained stable over time, interpretation of faint positives fell to 76.7% correct at 12 months. We conclude that appropriately trained and supervised CHWs can use RDTs safely and accurately in community practice for up to 12 months post-training.


Available from: Busiku Hamainza, Jun 12, 2015
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