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Published in: Malaria Journal 1/2016

Open Access 01-12-2016 | Research

The complexities of simple technologies: re-imagining the role of rapid diagnostic tests in malaria control efforts

Authors: Uli Beisel, René Umlauf, Eleanor Hutchinson, Clare I. R. Chandler

Published in: Malaria Journal | Issue 1/2016

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Abstract

Background

Malaria rapid diagnostic tests (RDTs) are assumed to be simple-to-use and mobile technologies that have the capacity to standardize parasitological diagnosis for malaria across a variety of clinical settings. In order to evaluate these tests, it is important to consider how such assumptions play out in practice, in everyday settings of clinics, health centres, drug stores and for community health volunteers.

Methods

This paper draws on qualitative research on RDTs conducted over the last nine years. In particular the study reports on four qualitative case studies on the use of RDTs from Uganda, Tanzania and Sierra Leone, including qualitative interviews, focus group discussions and participant observation.

Results

Results suggest that while RDTs may be simple to use as stand-alone technological tools, it is not trivial to make them work effectively in a variety of economically pressured health care settings. The studies show that to perform RDTs effectively might very well need exactly the infrastructure they were designed to substitute: the medical expertise, organizational capacity and diagnostic and treatment options of well-funded and functioning health systems.

Conclusions

These results underline that successful malaria diagnosis and treatment requires as much investment in general health infrastructure as it does in new technologies.
Literature
1.
go back to reference Hopkins H, Asiimwe C, Bell D. Access to antimalarial therapy: accurate diagnosis is essential to achieving long term goals. BMJ. 2009;339:b2606.CrossRefPubMed Hopkins H, Asiimwe C, Bell D. Access to antimalarial therapy: accurate diagnosis is essential to achieving long term goals. BMJ. 2009;339:b2606.CrossRefPubMed
2.
go back to reference D’Acremont V, Lengeler C, Mshinda H, Mtasiwa D, Tanner M, Genton B. Time to move from presumptive malaria treatment to laboratory-confirmed diagnosis and treatment in African children with fever. PLoS Med. 2009;6:e252.PubMedCentralCrossRefPubMed D’Acremont V, Lengeler C, Mshinda H, Mtasiwa D, Tanner M, Genton B. Time to move from presumptive malaria treatment to laboratory-confirmed diagnosis and treatment in African children with fever. PLoS Med. 2009;6:e252.PubMedCentralCrossRefPubMed
3.
go back to reference Rafael ME, Taylor T, Magill A, Lim YW, Girosi F, Allan R. Reducing the burden of childhood malaria in Africa: the role of improved diagnostics. Nature. 2006;444(Suppl 1):39–48.CrossRefPubMed Rafael ME, Taylor T, Magill A, Lim YW, Girosi F, Allan R. Reducing the burden of childhood malaria in Africa: the role of improved diagnostics. Nature. 2006;444(Suppl 1):39–48.CrossRefPubMed
6.
go back to reference Mabey D, Peeling RW, Ustianowski A, Perkins MD. Tropical infectious diseases: diagnostics for the developing world. Nat Rev Micro. 2004;2:231–40.CrossRef Mabey D, Peeling RW, Ustianowski A, Perkins MD. Tropical infectious diseases: diagnostics for the developing world. Nat Rev Micro. 2004;2:231–40.CrossRef
7.
go back to reference Frost LJ, Reich M. Access: how do good health technologies get to poor people in poor countries? Cambridge. Massacheusetts: Harvard University Press; 2009. Frost LJ, Reich M. Access: how do good health technologies get to poor people in poor countries? Cambridge. Massacheusetts: Harvard University Press; 2009.
8.
go back to reference Bijker WE, Hughes TP, Pinch TJ. The Social Construction of Technological Systems: New Directions in the Sociology and History of Technology. Cambridge and London: MIT Press; 1989. Bijker WE, Hughes TP, Pinch TJ. The Social Construction of Technological Systems: New Directions in the Sociology and History of Technology. Cambridge and London: MIT Press; 1989.
9.
go back to reference MacKenzie DA, Wajcman J. The social shaping of technology: how the refrigerator got its hum. Milton Keynes: Open University Press; 1985. MacKenzie DA, Wajcman J. The social shaping of technology: how the refrigerator got its hum. Milton Keynes: Open University Press; 1985.
10.
go back to reference Oudshoorn N, Pinch TJ. How users matter: the co-construction of users and technology. Cambridge and London: MIT Press; 2005. Oudshoorn N, Pinch TJ. How users matter: the co-construction of users and technology. Cambridge and London: MIT Press; 2005.
11.
go back to reference Reyburn H, Mbakilwa H, Mwangi R, Mwerinde O, Olomi R, Drakeley C, et al. Rapid diagnostic tests compared with malaria microscopy for guiding outpatient treatment of febrile illness in Tanzania: randomised trial. BMJ. 2007;334:403.PubMedCentralCrossRefPubMed Reyburn H, Mbakilwa H, Mwangi R, Mwerinde O, Olomi R, Drakeley C, et al. Rapid diagnostic tests compared with malaria microscopy for guiding outpatient treatment of febrile illness in Tanzania: randomised trial. BMJ. 2007;334:403.PubMedCentralCrossRefPubMed
12.
go back to reference Stewart L, Gosling R, Griffin J, Gesase S, Campo J, Hashim R, et al. Rapid assessment of malaria transmission using age-specific sero-conversion rates. PLoS One. 2009;4:e6083.PubMedCentralCrossRefPubMed Stewart L, Gosling R, Griffin J, Gesase S, Campo J, Hashim R, et al. Rapid assessment of malaria transmission using age-specific sero-conversion rates. PLoS One. 2009;4:e6083.PubMedCentralCrossRefPubMed
13.
go back to reference Cundill B, Mbakilwa H, Chandler CIR, Mtove G, Mtei F, Willetts A, et al. Prescriber and patient-oriented behavioural interventions to improve use of malaria rapid diagnostic tests in Tanzania: facility-based cluster randomised trial. BMC Med. 2015;13:118.PubMedCentralCrossRefPubMed Cundill B, Mbakilwa H, Chandler CIR, Mtove G, Mtei F, Willetts A, et al. Prescriber and patient-oriented behavioural interventions to improve use of malaria rapid diagnostic tests in Tanzania: facility-based cluster randomised trial. BMC Med. 2015;13:118.PubMedCentralCrossRefPubMed
14.
go back to reference Hutchinson E, Reyburn H, Hamlyn E, Long K, Meta J, Mbakilwa H, Chandler C. Bringing the state into the clinic? Incorporating the rapid diagnostic test for malaria into routine practice in Tanzanian primary healthcare facilities. Glob Public Health. 2015. doi:10.1080/17441692.2015.1091025.PubMed Hutchinson E, Reyburn H, Hamlyn E, Long K, Meta J, Mbakilwa H, Chandler C. Bringing the state into the clinic? Incorporating the rapid diagnostic test for malaria into routine practice in Tanzanian primary healthcare facilities. Glob Public Health. 2015. doi:10.​1080/​17441692.​2015.​1091025.PubMed
15.
go back to reference Hutchinson E, Chandler C, Clarke S, Lal S, Magnussen P, Kayendeke M, Nabirye C, Kizito J, Mbonye A. ‘It puts life in us and we feel big’: shifts in the local health care system during the introduction of rapid diagnostic tests for malaria into drug shops in Uganda. Crit Public Health. 2015;25(1):48–62.PubMedCentralCrossRefPubMed Hutchinson E, Chandler C, Clarke S, Lal S, Magnussen P, Kayendeke M, Nabirye C, Kizito J, Mbonye A. ‘It puts life in us and we feel big’: shifts in the local health care system during the introduction of rapid diagnostic tests for malaria into drug shops in Uganda. Crit Public Health. 2015;25(1):48–62.PubMedCentralCrossRefPubMed
16.
go back to reference Mol A. The body multiple: ontology in medical practice. Durham and London: Duke University Press; 2002.CrossRef Mol A. The body multiple: ontology in medical practice. Durham and London: Duke University Press; 2002.CrossRef
Metadata
Title
The complexities of simple technologies: re-imagining the role of rapid diagnostic tests in malaria control efforts
Authors
Uli Beisel
René Umlauf
Eleanor Hutchinson
Clare I. R. Chandler
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2016
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-016-1083-2

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