[afro-nets] Malaria ... about Rapid Diagnosis Kits (3)

["Robert Karanja" <RKaranja@kemri.org>]

Hi Peter,

The jury is still out concerning the feasibility of RDTs in malaria i.e. financial and otherwise.  According to Zurovac et al what we have is a mixed bag of results depending on level of transmission (at least for Kenya). Check out their paper, whose abstract I've copy pasted below. 

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Am. J. Trop. Med. Hyg., 78(6), 2008, pp. 884-891
Modeling the Financial and Clinical Implications of Malaria Rapid
Diagnostic Tests in the Case-management of Older Children and Adults in Kenya

Dejan Zurovac,* Bruce A. Larson, Jacek Skarbinski, Laurence Slutsker, Robert W. Snow, and Mary J. Hamel

Abstract. Using data on clinical practices for outpatients 5 years and older, test accuracy, and malaria prevalence, we model financial and clinical implications of malaria rapid diagnostic tests (RDTs) under the new artemetherlumefantrine (AL) treatment policy in one high and one low malaria prevalence district in Kenya. In the high transmission district, RDTs as actually used would improve malaria treatment (61% less over-treatment but 8% more under-treatment) and lower costs (21% less). Nonetheless, the majority of patients with malaria would not be correctly treated with AL. In the low transmission district, especially because the treatment policy was new and AL was not widely used, RDTs as actually used would yield a minor reduction in under-treatment errors (36% less but the base is small) with 41% higher costs. In both districts, adherence to revised clinical practices with RDTs has the potential to further decrease treatment errors with acceptable costs.
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I'd appreciate your critique on this.

With regards,

Robert Karanja
mailto:RKaranja@kemri.org