A cross-sectional evaluation of the health workers' competence in performing RDTs was conducted six weeks following the training, incorporating observation, in-depth interviews with health workers and the review of health facility records relating to tests offered and antimalarial drug (AMD) prescriptions pre and post training.
In the private outlets sampled, the availability of RDTs was limited. Some of the RDTs whose quality we tested demonstrated inadequate sensitivity.
Prescription of antibiotics in patients with febrile illness is high.
Comprehension of IVD symbols on RDTs among laboratory staff in four international settings was unsatisfactory.
Malaria confirmation before treatment provides an opportunity for improving the quality of malaria case management in endemic regions.
The findings suggest that RDTs and PCR may have good performance characteristics to serve as alternatives for the diagnosis of malaria in pregnancy, besides any other limitations and practical considerations concerning the use of these tests.
Use of HRP-2 RDTs to detect malaria in pregnancy in symptomatic women was accurate when performed by midwives.
The performances of all four malaria RDT kits were acceptable, although Humasis Malaria P.f/Pan antigen test and CareStartTM Malaria Pf/Pv Combo test gave superior performances with ROK isolates.
Use of RDTs to direct the use of anti-malarial drugs in young children did not result in any missed diagnoses of malaria although new infections soon after a consultation with a negative RDT result may undermine confidence in results.
These results suggest that false-negative malaria RDT results will rarely occur due to a prozone-like effect in high-density infections, and other causes are more likely.