Investigating perceptions towards rapid diagnostic tests for malaria

Despite significant strides in controlling the incidence of malaria in Nigeria over the last decade, effective case management and treatment of the disease has not kept pace. We were commissioned by the Malaria Consortium in Nigeria to conduct an endline assessment study that would provide an update on the knowledge and accessibility of Rapid Diagnostic Test (RDT) use for consumers, client satisfaction, the quality of care in malaria case management, and associated issues arising from strategic interventions geared at malaria case management and diagnosis. The focus was on the private sector in three states.

Challenges

The acceptability of incorporating malaria diagnosis into treatment practices, and of RDTs in particular, remains poorly understood. Aside from the financial and time costs associated with such an approach, it is unclear whether patients suffering from malaria-related symptoms value diagnosis in itself. Furthermore, the acceptability of RDTs among Nigerians who frequent pharmacies and proprietary patent medicine vendors is unknown despite the critical role these outlets play in providing broad access to non-prescribed antimalarial drugs.

This study was designed to address these knowledge gaps by providing information on malaria diagnostics and case management in the private sector including the current state of RDT use in selected project states as well as associated issues arising from strategic interventions across Nigeria as a whole.

Our approach

We designed and implemented a multi-component study using both primary and secondary research techniques to access the knowledge, attitude and perception of respondents (caregivers and fever patients) and service providers towards malaria case management in three states: Anambra, Cross River and Ogun.

• We conducted a comprehensive desk review, pilot testing and actual field interviews using the household, client and mystery client survey instruments.
• In addition, we reviewed the impact of the UNITAID Private Sector QARDT project i on the target population –intervention communities (sampled households), fever patients at the health facilities and service providers supported by the project in the eight Local Government Areas across the three states.

Outcomes

This project has helped improve understanding around patient perception of Rapid Diagnostic Tests (RDTs) for malaria in Nigeria. By focusing on private sector providers, it has provided insights to inform effective design and scale-up strategies that will enhance malaria diagnosis and ultimately shape the market incentives for providing RDTs in the sector.