@article{Kiemde2018-mo,

title = {Implementation of a malaria rapid diagnostic test in a rural  setting of Nanoro, Burkina Faso: from expectation to reality},

author = {Francois Kiemde and Marc Christian Tahita and Massa Dit Achille Bonko and Petra F Mens and Halidou Tinto and Michael Boele Hensbroek and Henk D F H Schallig},

doi = {10.1186/s12936-018-2468-1},

year  = {2018},

date = {2018-08-01},

urldate = {2018-08-01},

journal = {Malar. J.},

volume = {17},

number = {1},

pages = {316},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: Malaria rapid diagnostic tests (RDTs) are nowadays 

 widely used in malaria endemic countries as an alternative to 

 microscopy for the diagnosis of malaria. However, quality 

 control of test performance and execution in the field are 

 important in order to ensure proper use and adequate diagnosis 

 of malaria. The current study compared the performance of a 

 histidine-rich protein 2-based RDT used at peripheral health 

 facilities level in real life conditions with that performed at 

 central reference laboratory level with strict adherence to 

 manufacturer instructions. METHODS: Febrile children attending 

 rural health clinics were tested for malaria with a RDT provided 

 by the Ministry of Health of Burkina Faso as recommended by the 

 National Malaria Control Programme. In addition, a blood sample 

 was collected in an EDTA tube from all study cases for retesting 

 with the same brand of RDT following the manufacturer's 

 instructions with expert malaria microscopy as gold standard at 

 the central reference laboratory. Fisher exact test was used to 

 compare the proportions by estimating the p-value (p $\leq$ 

 0.05) as statistically significant. RESULTS: In total, 407 

 febrile children were included in the study and malaria was 

 diagnosed in 59.9% (244/407) of the cases with expert malaria 

 microscopy. The sensitivity of malaria RDT testing performed at 

 health facilities was 97.5% and comparable to that achieved at 

 the laboratory (98.8%). The number of malaria false negatives was not statistically significant between the two groups (p = 

 0.5209). However, the malaria RDT testing performed at health 

 facilities had a specificity issue (52.8%) and was much lower 

 compared to RDT testing performed at laboratory (74.2%). The 

 number of malaria false positives was statistically significantly different between the two groups (p = 0.0005). 

 CONCLUSION: Malaria RDT testing performed at the participating 

 rural health facilities resulted in more malaria false positives 

 compared to those performed at central laboratory. Several 

 factors, including storage and transportation conditions but 

 also training of health workers, are most likely to influence 

 test performance. Therefore, it is very important to have 

 appropriate quality control and training programmes in place to 

 ensure correct performance of RDT testing.},

keywords = {HRP-2; Malaria; Microscopy; RDT; Sensitivity and specificity},

pubstate = {published},

tppubtype = {article}

}