Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review.

<h4>Background</h4>Many patients with malaria-like symptoms seek treatment in private medicine retail outlets (PMR) that distribute malaria medicines but do not traditionally provide diagnostic services, potentially leading to overtreatment with antimalarial drugs. To achieve universal a...

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Main Authors: Theodoor Visser, Katia Bruxvoort, Kathleen Maloney, Toby Leslie, Lawrence M Barat, Richard Allan, Evelyn K Ansah, Jennifer Anyanti, Ian Boulton, Siân E Clarke, Jessica L Cohen, Justin M Cohen, Andrea Cutherell, Caitlin Dolkart, Katie Eves, Günther Fink, Catherine Goodman, Eleanor Hutchinson, Sham Lal, Anthony Mbonye, Obinna Onwujekwe, Nora Petty, Julie Pontarollo, Stephen Poyer, David Schellenberg, Elizabeth Streat, Abigail Ward, Virginia Wiseman, Christopher J M Whitty, Shunmay Yeung, Jane Cunningham, Clare I R Chandler
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0173093
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author Theodoor Visser
Katia Bruxvoort
Kathleen Maloney
Toby Leslie
Lawrence M Barat
Richard Allan
Evelyn K Ansah
Jennifer Anyanti
Ian Boulton
Siân E Clarke
Jessica L Cohen
Justin M Cohen
Andrea Cutherell
Caitlin Dolkart
Katie Eves
Günther Fink
Catherine Goodman
Eleanor Hutchinson
Sham Lal
Anthony Mbonye
Obinna Onwujekwe
Nora Petty
Julie Pontarollo
Stephen Poyer
David Schellenberg
Elizabeth Streat
Abigail Ward
Virginia Wiseman
Christopher J M Whitty
Shunmay Yeung
Jane Cunningham
Clare I R Chandler
author_facet Theodoor Visser
Katia Bruxvoort
Kathleen Maloney
Toby Leslie
Lawrence M Barat
Richard Allan
Evelyn K Ansah
Jennifer Anyanti
Ian Boulton
Siân E Clarke
Jessica L Cohen
Justin M Cohen
Andrea Cutherell
Caitlin Dolkart
Katie Eves
Günther Fink
Catherine Goodman
Eleanor Hutchinson
Sham Lal
Anthony Mbonye
Obinna Onwujekwe
Nora Petty
Julie Pontarollo
Stephen Poyer
David Schellenberg
Elizabeth Streat
Abigail Ward
Virginia Wiseman
Christopher J M Whitty
Shunmay Yeung
Jane Cunningham
Clare I R Chandler
author_sort Theodoor Visser
collection DOAJ
description <h4>Background</h4>Many patients with malaria-like symptoms seek treatment in private medicine retail outlets (PMR) that distribute malaria medicines but do not traditionally provide diagnostic services, potentially leading to overtreatment with antimalarial drugs. To achieve universal access to prompt parasite-based diagnosis, many malaria-endemic countries are considering scaling up malaria rapid diagnostic tests (RDTs) in these outlets, an intervention that may require legislative changes and major investments in supporting programs and infrastructures. This review identifies studies that introduced malaria RDTs in PMRs and examines study outcomes and success factors to inform scale up decisions.<h4>Methods</h4>Published and unpublished studies that introduced malaria RDTs in PMRs were systematically identified and reviewed. Literature published before November 2016 was searched in six electronic databases, and unpublished studies were identified through personal contacts and stakeholder meetings. Outcomes were extracted from publications or provided by principal investigators.<h4>Results</h4>Six published and six unpublished studies were found. Most studies took place in sub-Saharan Africa and were small-scale pilots of RDT introduction in drug shops or pharmacies. None of the studies assessed large-scale implementation in PMRs. RDT uptake varied widely from 8%-100%. Provision of artemisinin-based combination therapy (ACT) for patients testing positive ranged from 30%-99%, and was more than 85% in five studies. Of those testing negative, provision of antimalarials varied from 2%-83% and was less than 20% in eight studies. Longer provider training, lower RDT retail prices and frequent supervision appeared to have a positive effect on RDT uptake and provider adherence to test results. Performance of RDTs by PMR vendors was generally good, but disposal of medical waste and referral of patients to public facilities were common challenges.<h4>Conclusions</h4>Expanding services of PMRs to include malaria diagnostic services may hold great promise to improve malaria case management and curb overtreatment with antimalarials. However, doing so will require careful planning, investment and additional research to develop and sustain effective training, supervision, waste-management, referral and surveillance programs beyond the public sector.
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spelling doaj-art-b6ab5c437ada4eaa8864760b3bae6d432025-08-20T03:32:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01123e017309310.1371/journal.pone.0173093Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review.Theodoor VisserKatia BruxvoortKathleen MaloneyToby LeslieLawrence M BaratRichard AllanEvelyn K AnsahJennifer AnyantiIan BoultonSiân E ClarkeJessica L CohenJustin M CohenAndrea CutherellCaitlin DolkartKatie EvesGünther FinkCatherine GoodmanEleanor HutchinsonSham LalAnthony MbonyeObinna OnwujekweNora PettyJulie PontarolloStephen PoyerDavid SchellenbergElizabeth StreatAbigail WardVirginia WisemanChristopher J M WhittyShunmay YeungJane CunninghamClare I R Chandler<h4>Background</h4>Many patients with malaria-like symptoms seek treatment in private medicine retail outlets (PMR) that distribute malaria medicines but do not traditionally provide diagnostic services, potentially leading to overtreatment with antimalarial drugs. To achieve universal access to prompt parasite-based diagnosis, many malaria-endemic countries are considering scaling up malaria rapid diagnostic tests (RDTs) in these outlets, an intervention that may require legislative changes and major investments in supporting programs and infrastructures. This review identifies studies that introduced malaria RDTs in PMRs and examines study outcomes and success factors to inform scale up decisions.<h4>Methods</h4>Published and unpublished studies that introduced malaria RDTs in PMRs were systematically identified and reviewed. Literature published before November 2016 was searched in six electronic databases, and unpublished studies were identified through personal contacts and stakeholder meetings. Outcomes were extracted from publications or provided by principal investigators.<h4>Results</h4>Six published and six unpublished studies were found. Most studies took place in sub-Saharan Africa and were small-scale pilots of RDT introduction in drug shops or pharmacies. None of the studies assessed large-scale implementation in PMRs. RDT uptake varied widely from 8%-100%. Provision of artemisinin-based combination therapy (ACT) for patients testing positive ranged from 30%-99%, and was more than 85% in five studies. Of those testing negative, provision of antimalarials varied from 2%-83% and was less than 20% in eight studies. Longer provider training, lower RDT retail prices and frequent supervision appeared to have a positive effect on RDT uptake and provider adherence to test results. Performance of RDTs by PMR vendors was generally good, but disposal of medical waste and referral of patients to public facilities were common challenges.<h4>Conclusions</h4>Expanding services of PMRs to include malaria diagnostic services may hold great promise to improve malaria case management and curb overtreatment with antimalarials. However, doing so will require careful planning, investment and additional research to develop and sustain effective training, supervision, waste-management, referral and surveillance programs beyond the public sector.https://doi.org/10.1371/journal.pone.0173093
spellingShingle Theodoor Visser
Katia Bruxvoort
Kathleen Maloney
Toby Leslie
Lawrence M Barat
Richard Allan
Evelyn K Ansah
Jennifer Anyanti
Ian Boulton
Siân E Clarke
Jessica L Cohen
Justin M Cohen
Andrea Cutherell
Caitlin Dolkart
Katie Eves
Günther Fink
Catherine Goodman
Eleanor Hutchinson
Sham Lal
Anthony Mbonye
Obinna Onwujekwe
Nora Petty
Julie Pontarollo
Stephen Poyer
David Schellenberg
Elizabeth Streat
Abigail Ward
Virginia Wiseman
Christopher J M Whitty
Shunmay Yeung
Jane Cunningham
Clare I R Chandler
Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review.
PLoS ONE
title Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review.
title_full Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review.
title_fullStr Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review.
title_full_unstemmed Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review.
title_short Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review.
title_sort introducing malaria rapid diagnostic tests in private medicine retail outlets a systematic literature review
url https://doi.org/10.1371/journal.pone.0173093
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