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Research: Misdiagnosis of malaria using wrong buffer substitutes for rapid diagnostic tests in poor resource setting in Enugu, southeast Nigeria

May 12, 2014 - 12:31 -- Bart G.J. Knols
Johnbull S. Ogboi, Polycarp U. Agu, Adeniyi F. Fagbamigbe, Onyemocho Audu, Augustine Akubue, Ifeyinwa Obianwu
MWJ 2014, 5, 6
Article type: 
This study explored the phenomenon of using the wrong buffer vial (often a kit from another brand or buffer from HIV rapid test kits), dextrose, saline or distilled water among health care providers who used RDTs for malaria diagnosis in resource poor settings in Enugu South East, Nigeria. Of the 80 study participants that completed their questionnaires, 56.3% reported that malaria diagnosis was positive using non-buffer RDTs detection while others reported negative results. Among the various professionals who used RDTs, 76.2% reported to have run out of RDT buffer stock at least once. Of the study participants that ran out of RDT buffer solution, 73% declared to have used non-RDT alternatives (physiological saline, 0.9% NaCl), distilled water, HIV buffer or ordinary water). Only 30% had received formal training on the proper usage and application of RDTs while 70% had never received any formal training on RDTs but learnt the technique of using RDT on the job. This study demonstrated that at least three quarters of health care workers in a resource poor setting had run out of buffer when using malaria RDTs and that the majority of them had used buffer substitutes, which are known to generate inaccurate tests results. This has the consequence of misdiagnosis, thus potentially damaging the credibility of malaria control.


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Erwan Piriou's picture
Submitted by Erwan Piriou on
"Even" RDTs do require training before shown also nicely in this beautiful picture report of a malaria outbreak in the Indian Tripura state: Just putting the blood in the right well is apparently not that easy...

Erwan Piriou, PhD

Médecins Sans Frontières - OCA

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