RDT

It was more feasible to implement parasite-based diagnosis for malaria using RDT than with microscopy.

A robust surveillance-response system is essential when moving towards malaria elimination.

RDTs in the hands of CHWs may safely improve early and well-targeted ACT treatment in malaria patients at community level in Africa.

Remote sensing technologies can be used to target malaria control interventions in a region of declining malaria transmission in southern Zambia, enabling a more efficient use of resources for malaria elimination.

CHWs are effective delivery points for prompt and effective malaria case management at community level.

We compared two recent methods (the novel Partec Rapid Malaria Test(R) (PT) and the Binax Now(R) Malaria Rapid Diagnostic Test (BN RDT) with the conventional Giemsa stain microscopy (GM) for the diagnosis of malaria among children in a clinical laboratory of a hospital in a rural endemic area of Ghana.

For children with severe febrile illness, at least two reliable negative parasitological test results should be available to justify withholding antimalarial treatment; the optimal choice of these has yet to be identified.

PCR has proven to be one of the most specific and sensitive diagnostic methods, particularly for malaria cases with low parasitaemia.

Use of RDTs by CMDs is likely to be acceptable by community members given that CMDs are properly trained, and receive regular technical supervision and logistical support. A well-designed behaviour change communication strategy is needed to address the anticipated programmatic challenges as well as community fears and stigma about drawing blood.

Use of RDTs resulted in a 2-fold reduction in anti-malarial drug prescription at LLHCFs. The study demonstrated that RDT use is feasible at LLHCFs, and can lead to better targetting of malaria treatment.