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Malar J. 2009 Dec 23;8:308. doi: 10.1186/1475-2875-8-308.

Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo.

Author information

  • 1University of Toronto, 101 College St, Suite 10-401, Toronto, Ontario, Canada. michael.hawkes@utoronto.ca

Abstract

BACKGROUND:

Accurate and practical malaria diagnostics, such as immunochromatographic rapid diagnostic tests (RDTs), have the potential to avert unnecessary treatments and save lives. Volunteer community health workers (CHWs) represent a potentially valuable human resource for expanding this technology to where it is most needed, remote rural communities in sub-Saharan Africa with limited health facilities and personnel. This study reports on a training programme for CHWs to incorporate RDTs into their management strategy for febrile children in the Democratic Republic of Congo, a tropical African setting ravaged by human conflict.

METHODS:

Prospective cohort study, satisfaction questionnaire and decision analysis.

RESULTS:

Twelve CHWs were trained to safely and accurately perform and interpret RDTs, then successfully implemented rapid diagnostic testing in their remote community in a cohort of 357 febrile children. CHWs were uniformly positive in evaluating RDTs for their utility and ease of use. However, high malaria prevalence in this cohort (93% by RDTs, 88% by light microscopy) limited the cost-effectiveness of RDTs compared to presumptive treatment of all febrile children, as evidenced by findings from a simplified decision analysis.

CONCLUSIONS:

CHWs can safely and effectively use RDTs in their management of febrile children; however, cost-effectiveness of RDTs is limited in zones of high malaria prevalence.

PMID:
20028563
[PubMed - indexed for MEDLINE]
PMCID:
PMC2804690
Free PMC Article

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