Understanding the impact of malaria rapid diagnostic test (RDT) use on management of acute febrile disease at a community level, and on the consumption of anti-malarial medicines, is critical to the planning and success of scale-up to universal parasite-based diagnosis by health systems in malaria-endemic countries. This article, based on a retrospective study of district-wide community-level RDT introduction, assesses the impact on malaria reporting, incidence of mortality and on district anti-malarial consumption.

The authors report that the RDT introduction led to a large decline in reported malaria cases and in ACT consumption in Livingstone district. Reported malaria mortality declined to zero, indicating the safety of the new diagnostic regime, although adherence to the regime and use of RDTs remained incomplete. The authors further reported an apparent deficiency in management of non-malarial fever, with inappropriate use of a low-cost single dose drug, SP, replacing ACT. While large gains have been achieved, the full potential of RDTs will only be realized when strategies can be put in place to better manage RDT-negative cases.

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Citation: Freddie Masaninga et al (2012). Finding parasites and finding challenges: improved diagnostic access and trends in reported malaria and anti-malarial drug use in Livingstone district, Zambia. Malaria Journal 2012, 11:341 doi:10.1186/1475-2875-11-341

Country: Zambia