Ten Years of Universal Testing: How the Rapid Diagnostic Test Became a Game Changer for Malaria Case Management and Improved Disease Reporting

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  • 1 Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;
  • | 2 Foundation for Innovative New Diagnostics, Geneva, Switzerland

In 2010, the World Health Organization changed its guidance on malaria case management, recommending parasitological confirmation of all suspected cases before treatment with an antimalarial. This recommendation was in large part as a result of the availability of quality assured malaria rapid diagnostic tests (RDTs) that made it possible for malaria diagnosis to be performed by laboratory staff in all health facilities irrespective of the facility’s place in the tiered health system. Community health workers and other non-laboratory health workers who traditionally did not perform malaria testing due to the technical and logistic demands of smear microscopy were now able to test for malaria. The use of RDTs has led to substantial increases in testing rates, improved quality of case management, as well as more accurate reporting of malaria cases. Although current RDTs have limitations, they remain one of the most important tools in contemporary malaria control. Further improvements to existing products, such as increased sensitivity for non-falciparum tests, diversification of Plasmodium falciparum antigen targets, along with strengthened health system support for current RDTs will further enhance their utility in malaria control and prevention.

Author Notes

Address correspondence to Michael Aidoo, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333. E-mail: maidoo@cdc.gov

Financial support: S. I. was funded by the Foundation for Innovative New Diagnostics through a grant from the Australian Department of Foreign Affairs and Trade. The funding source was not involved in the development of the manuscript.

Disclosures: M. A. declares that he has no conflicts of interest. S. I. declares that she was employed by the Foundation for Innovative New Diagnostics at the time of writing this manuscript.

Disclaimer: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Authors’ addresses: Michael Aidoo, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention (CDC), Atlanta, GA, E-mail: maidoo@cdc.gov. Sandra Incardona, Medical Care Development International, Silver Spring, MA, E-mail: sincardona@mcd.org.

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