Online Program

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

Sunday, November 3, 2013

Andria Rusk, MScGH, Global Health Institute, Duke University, Durham, NC
Catherine Goodman, MSc, PhD, Global Health Development Department, London School of Hygiene and Tropical Medicine, London, England
Violet Naanyu, MA, PhD, School of Medicine, Department of Behavioral Sciences, Moi University, Eldoret, Kenya
Beatrice Koech, Moi University, Eldoret, Kenya
Andrew Obala, PhD, School of Medicine, Moi University, Eldoret, Kenya
Wendy Prudhomme O'Meara, PhD, School of Medicine, Global Health Institute, Duke University, Durham, NC
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.

Learning Areas:

Clinical medicine applied in public health
Provision of health care to the public

Learning Objectives:
Describe the risks of inaccurate diagnoses and of practicing presumptive diagnosis. Identify the opportunities of introducing rapid diagnostic tests in the retail medicine sector. Explain the perceptions that retail drug shop workers have toward using and selling rapid diagnostic tests (RDTs) in their shops. Compare the benefits to the challenges of implementing RDTs in the retail sector. Evaluate the best path forward for improving the accuracy of malaria diagnosis in this region.

Keyword(s): Infectious Diseases, Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the principle investigator on the project and the recipient of university funding to conduct the research. Among my research interests has been the behavioral and epidemiological predictors of malaria infection, and the development of strategies to prevent, quickly treat, and reduce the transmission of such infections.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.