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Malaria control programs in endemic countries increasingly rely on early case detection and treatment at village level. The rapid diagnostic tests (RDTs) and accompanying drugs on which the success of these programs depends deteriorate to varying degrees at high temperatures. To assess the ability of health systems to maintain RDTs within manufacturers’ specifications, we monitored temperatures in the delivery chain from manufacturer through to the village health worker in Cambodia and the Philippines. In both countries, storage temperatures regularly exceeded those recommended for most RDTs intended for field use, whereas temperatures during transport greatly exceeded the lower and upper limits. These results emphasize the need for good logistical planning during the introduction of point-of-care tests in tropical countries and the importance of considering the stability of diagnostic tests during procurement.
Received September 29, 2005. Accepted for publication December 6, 2005.
Acknowledgments: The authors gratefully acknowledge the cooperation of the Department of Health, the Philippines, and the National Center for Parasitology, Entomology, and Malaria Control, Cambodia, the support of Kilusan Ligtas Malaria, the Philippines, the assistance of village health workers in Palawan, the Philippines, and the health staff in Cambodia.
Financial support: This study was funded by the Australian Agency for International Development, United States Agency for International Development, United Kingdom Department for International Development through UNICEF-UNDP-World Bank-WHO Special Programme for Research and Training in Tropical Diseases/Product Research, (TDR) and WHO Roll Back Malaria Department.
* Address correspondence to David Bell, World Health Organization–Regional Office for the Western Pacific, PO Box 2932, United Nations Avenue, Manila 1000, The Philippines. E-mail: belld{at}wpro.who.int
Authors’ addresses: Pernille Jorgensen and David Bell, World Health Organization–Regional Office for the Western Pacific, PO Box 2932, United Nations Avenue, 1000 Manila, The Philippines, E-mail: belld{at}wpro.who.int. Lon Chanthap, National Center for Parasitology, Entomology and Malaria Control, 372 Monivong Boulevard, Phnom Penh, Cambodia, E-mail: chanthapl{at}cnm.gov.kh. Antero Rebueno, Kilusan Ligtas Malaria, Provincial Government of Palawan, PRIMM Building, Puerto Princesa City, 5300 Palawan, The Philippines. Reiko Tsuyuoka, World Health Organization, No. 177-179 Corner Pasteur (51) and 254, Phnom Penh, Cambodia, E-mail: tsuyuokar{at}lao.wpro.who.int.
Reprint requests: David Bell, World Health Organization-Regional Office for the Western Pacific, PO Box 2932, United Nations Avenue, Manila 1000, The Philippines. E-mail: belld{at}wpro.who.int.
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