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QAP Staff RDT Article Published by the Royal Society of Tropical Medicine and Hygiene

Quality Assurance Project (QAP) senior advisors Waverly Rennie and Steven Harvey co-authored an article entitled “Minimising human error in malaria rapid diagnosis: clarity of written instructions and health worker performance” published in the January 2007 Transactions of the Royal Society of Tropical Medicine and Hygiene.

The article describes how, in the Philippines and Laos, job aids to guide village health workers in correct use of rapid diagnostic tests (RDTs) for malaria resulted in significant improvements in correct administration of the tests. The usefulness of RDTs in malaria case management depends on the accuracy of the diagnosis they provide. As the article points out, previous studies show that despite the apparent simplicity of RDTs, their accuracy is highly user-dependent. As malaria RDTs will increasingly be used in remote areas with little supervision or support, minimizing mistakes is crucial.

The development of the RDT job aids was based on observations of common errors made by remote health workers and villagers in preparing and interpreting RDTs. The study found that use of the job aids in lieu of manufacturer’s instructions resulted in a significant increase in accurate use: in the Philippines, use of job aids with two different types of RDTs increased correct performance by 17%.

QAP is collaborating with the World Health Organization (WHO) and the Zambia National Malaria Control Center to field test job aids and a half-day training program to improve community health worker skills at preparing RDTs. Initial results suggest that with the job aid and a brief training, CHWs can complete 90% of test steps correctly, compared to only 60% when using the manufacturer’s instructions. Further studies are planned in 2007 to determine whether CHWs can maintain this improved performance up to six and 12 months after the training.

The article published in Transactions of the Royal Society of Tropical Medicine and Hygiene (2007, 101, 9-18) was authored by Waverly Rennie of QAP; Rattanaxay Phetsouvanh of the Center for Malariology, Parasitology and Entomology, Laos; Socorro Lupisan of the the Research Institute of Tropical Medicine, Philippines; Viengsay Vanisaveth, Bouasy Hongvanthong, and Samlane Phompida of the Center for Malariology, Parasitology and Entomology, Laos; Portia Alday and Mila Fulache of the Research Institute of Tropical Medicine, Philippines; Richard Lumagui of Arthphoto Marketing, Philippines; Pernille Jorgensen and David Bell of the WHO Regional Office for the Western Pacific, Philippines; and Steven Harvey of QAP.

For information on obtaining copies of the article, please contact Dr. Harvey at sharvey@urc-chs.com.

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