Expanding access to malaria diagnosis through retail shops in western Kenya: What do shop workers think?

Background: The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional, but can lead to overdiagnosis of malaria, delay in appropriate treatment, overprescription of antimalarials, and potential increases in drug resistance. Routine use of diagnostic tests can address many of these concerns. Though treatment is often procured from medicine retailers, there is low availability of rapid diagnostic tests for malaria (MRDTs), a simple, inexpensive, and accurate diagnostic solution. We know little about the challenges to expanding access to diagnostics through these outlets. Methods: To understand the perceptions of the benefits and challenges to selling rapid diagnostic tests for malaria, we conducted focus group discussions with antimalarial retailers who serve the residents of the Webuye Health and Demographic Surveillance Site in western Kenya. Results: Medicine retailers perceived MRDTs to be beneficial to their customers and businesses, saving time and money, improving accuracy of malaria diagnoses and resulting treatment, and increasing access to malaria diagnostic services for their customers. However, they also included cost, fear of the tests, risks of self-treatment, and regulatory concerns among the challenges to using and selling MRDTs. Conclusion: MRDTs represent a viable approach to increase access to malaria diagnostic testing. Medicine retailers are eager for MRDTs to be made available to them. However, certain challenges remain to implementation in retail outlets, and should be addressed in advance.