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Expert Panel July 5 - 20: Delivering Malaria Rapid Diagnostic Tests: Challenges from End-Users to Policy

By Ailis Tweed-Kent | 04 Jul, 2011 Last edited by Yue Guan on 15 Jul 2011

Dear colleagues, 

Starting today, July 5 and running until July 20, GHDonline is pleased to host a three session expert panel to discuss the challenges of delivering malaria rapid diagnostic tests in resource limited settings.

In the last decade, millions of malaria rapid diagnostic tests (RDTs) have been implemented worldwide. These simple and easy-to-use tests can diagnose malaria from blood in about 15 minutes, making a laboratory diagnosis possible at all levels of the health care system. While the tests have enabled better access to malaria diagnosis, many challenges still remain.

Session 1 (July 5 to July 10) will address the RDT test and the challenges with interpreting test results in context. What factors can influence the test quality and accuracy and how should these be addressed? Why are quality assurance/quality control programs important in RDTs? Expert panelists leading the discussion in this session include:
• Rosanna Peeling PhD, Chair and Professor of Diagnostics Research at the London School of Hygiene and Tropical Medicine.
• Sandra Incardona, the Technical Officer for Malaria Diagnostics at the Foundation for Innovative and New Diagnostics in Geneva, Switzerland.

Session 2 (July 11 to 14) will highlight challenges with RDTs and health care provider behavior. How have RDTs impacted health provider behavior? What are the implications of “test and treat” guidelines versus presumptive treatment? What do you do when the test is negative? Why is training important to rapid tests? Expert panelists leading the discussion in this session include:
• Wellington Oyibo, an Associate Professor in the College of Medicine at the University of Lagos, Nigeria
• Innocent Ali MSc, is a Poverty Related Diseases Fellow and PhD candidate at the Univeristy of Yaounde I in Cameroon
• Roger Peck, Technical Officer, Immunodiagnostics Portfolio Leader, PATH

Session 3 (July 15 to 20) will focus on policy issues including the assessment, procurement, and financing of RDTs. What regulatory approval should be required? What are challenges to successful implementation? Are RDTs cost-effective? How and where should they be integrated into existing systems? Expert panelists leading the discussion in this session include:
• Larry Barat, Senior Malaria Advisor at the USAID/President’s Malaria Initiative
• Paul Stannard, Deputy Director of Procurement, USAID/Deliver Project
• Megan Moynahan, Senior Advisor for Innovation, Center for Devices and Radiological Health, FDA

Does your organization use malaria RDTs? Do you face challenges that you could share? All GHDonline members can participate in this virtual discussion. Sign up to the community if you haven’t already joined and keep your email settings to “per post” to track the discussion live in your inbox. Each session will be held in a separate discussion thread.

We are looking forward to your participation.

Thank you,



esther ceus Replied at 1:26 PM, 5 Jul 2011

Commentaire sur le test de diagnostic rapide.(TDR)
Bien chers collègues et Participants,Je ne trouve pas assez de mots pour vous remercier pour ce beau travail que vous être en train des realisés.
Ma sugestion sur:
A)Sur les facteurs qui peuvent influencer lorsque à des défis à interpréter les résultats dans le vrai contexte, Ça pourrait causer un grand problème de faux diagnostique et jamais arriver à une solution exacte. Quand on a un faux diagnostique,on arrivera jamais à faire un vrai traitement. On trouve que ce programme de contrôle de qualité d’assurance et aussi a de qualité d’importance parce que cette méthode nous aide à mieux poser un diagnostic beaucoup plus certain.
Session 2
A)Pour que le TDR avoir un impact sur les comportements des prestataires de santé,il faut que chacun de nous prendre à coeur notre préocupation et aussi voir l’importance du TDR. Pour moi spécialement dans un centre de santé où je suis affectée,je traite mes patients seulement avec les signes et symptômes .Parce que je n'ai pas d’autres moyens même pour les autres tests.
B)Les implications de tester et traiter par rapport aux directives du traitement présomptifs :En realité pour qu'un médecin traite un patient,il faut qu'il a un diagnostic présomptif(avec tous les signes et symptômes que présente le patient) il manque qu'un test d’assurance pour lui guider à faire un vrai traitement plus efficace.
C) Lorsqu'on a un patient hypertermique et qu'on doute de l’origine ou cause,le préstataire doit demande au patient à faire deux tests qui sont :Widal test et Malaria test. Maintenant après les résultats si l’un est positif on le traite. mais si les deux sont positifs on fait un traitement combiné.
Cette méthode serrait mieux pour nous de diagnostiquer plus rapide la malaria.
D)Pour la dernière question,j’aimerais savoir de quelle formation parlez-vous.
Esther Ceus

Innocent ALI Replied at 5:16 AM, 9 Jul 2011

Hi Esther, Thanks for your comments. I totally agree with you that it is of paramount importance to ensure a credible quality assurance program that should accompany the implementation and use of RDTs at all levels of the health system. Many different factors exist as mentioned in the session one that affect the reliability of RDTs and hence the credibility of thr results. This in turn affects hos clinicians perceive the utility of this very important tool for decision making. About your recommendation for managing a feverish child, this is current practice in most health settings in malarious countries. I am wondering why physicians would demand for the malaria and Widal test; given that even a positive Widal test is not an indication of active infection. While we hope for the development of a simple multiplex RDT that will distinguish fevers of unknown origins, it would be helpful to advocate for the use of evidence based malaria RDTs for clinical decision making and for the development and implementation of a robust algorithm for clinical differentiation of fevers.

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