NEWS: Malaria Consortium at MIM 2009 - Community Health Workers: Are They Getting the Diagnosis Right?

3 November 2009
Nairobi, 3 November 2009: Many malaria-endemic countries realise the importance of home management of malaria in rural settings to reduce mortality in children. However, there are concerns about blood-safety and accuracy of diagnosis when community health workers use malaria rapid diagnostic tests (RDTs). Malaria Consortium reveals research findings to show whether these concerns are justified.

Speaking at the Multilateral Initiative on Malaria Conference in Kenya today, Helen Counihan, public health specialist at Malaria Consortium, introduced the results of a multi-organisational Zambian study into the effective use of RDTs among community health workers after they had completed a half-day training programme. This training programme was developed by WHO and partners and refined after testing and feedback from community health workers in Zambia.

Sixty-five community health workers in Livingstone district received training and were then sent home with all materials necessary to implement home management activities, explained Counihan. Their performance was assessed in their homes by observers at three, six and 12 months post-training. This included assessments to ensure test results were interpreted correctly and that safe procedures for handling blood and disposing of bio-hazardous waste were followed.

“Despite minimal supervision, most community health workers performed all essential steps correctly at six months, and performance remained very high at 12 months,” said Counihan. “Some required extra support and refresher training, however, demonstrating that training works best with follow-up support and supervision. The main challenges were less the incorrect interpretation of results or poor safety but more a lack of support from health facilities and RDT stock-outs.“

The study provides a model for other countries as they roll out community-based diagnosis and treatment of malaria.  It demonstrates how a proven strategy of using a well-structured training and job-aid is important in enabling community health workers to use malaria RDTs accurately and safely in a sub-Saharan setting at community level.

The feedback from the study experience is also being used to revise the training tools which are freely available on the following WHO website:
http://www.wpro.who.int/sites/rdt/using_rdts/training/

Other participants in the study were the University Research Co, Zambia National Malaria Control Centre, World Health Organization and Foundation for Innovative New Diagnostics.

For more information, please contact Diana Thomas, [email protected]