MALARIA CONSORTIUM - UGANDA

Assessment of operational accuracy of the ICT Pf rapid diagnostic test for malaria.

Uganda has recently changed its malaria drug policy from chloroquine and sulphadoxine-pyremethamine (CQ+SP) to Artemisinin-based Combination Therapy (ACT) using Coartem TM as the first line treatment. Previously with the CQ+SP combination therapy, malaria was diagnosed clinically. However, the new ACT drugs are much more expensive making this option unsustainable. Now more accurate diagnosis is needed to minimise wastage of SCT and to protect development of drug resistance. A shift away from presumptive treatment to targeted treatment is being encouraged in areas where this approach is cost-effective.

The gold standard for malaria diagnosis is microscopy but this is not always available or feasible to maintain in the peripheral health service. In contexts where this is the case, a possible alternative method is the use of rapid diagnostic tests (RDTs). In the past decade there have been many developments and refinements of malaria RDTs and the ones available now are much more robust and cheaper than the earlier versions. The Ugandan National Malaria Control Programme is keen to assess the role that RDTs may have in case manegement of uncomplicated malaria at health-care facility and community levels. The Ministry of Health does not have a policy on RDTs yet but intends to have one in place when their roles are ascertained. This study was carried out on collaboration with the aim of generating evidence-based policy decision pertaining RDTs in Uganda. In this study, the sensitivity, specificity, positive predictive value and ease use of the ICT rapid test in the detection of P.falciparum infections was compared with standard microscopic test.