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Feasibility of Distributing Rapid Diagnostic Tests for Malaria in the Retail Sector: Evidence from an Implementation Study in Uganda

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  • Jessica Cohen
  • Günther Fink
  • Katrina Berg
  • Flavia Aber
  • Matthew Jordan
  • Kathleen Maloney
  • William Dickens

Abstract

Background: Despite the benefits of malaria diagnosis, most presumed malaria episodes are never tested. A primary reason is the absence of diagnostic tests in retail establishments, where many patients seek care. Malaria rapid diagnostic tests (RDTs) in drug shops hold promise for guiding appropriate treatment. However, retail providers generally lack awareness of RDTs and training to administer them. Further, unsubsidized RDTs may be unaffordable to patients and unattractive to retailers. This paper reports results from an intervention study testing the feasibility of RDT distribution in Ugandan drug shops. Methods and Findings: 92 drug shops in 58 villages were offered subsidized RDTs for sale after completing training. Data on RDT purchases, storage, administration and disposal were collected, and samples were sent for quality testing. Household surveys were conducted to capture treatment outcomes. Estimated daily RDT sales varied substantially across shops, from zero to 8.46 RDTs per days. Overall compliance with storage, treatment and disposal guidelines was excellent. All RDTs (100%) collected from shops passed quality testing. The median price charged for RDTs was 1000USH ($0.40), corresponding to a 100% markup, and the same price as blood slides in local health clinics. RDTs affected treatment decisions. RDT-positive patients were 23 percentage points more likely to buy Artemisinin Combination Therapies (ACTs) (p = .005) and 33.1 percentage points more likely to buy other antimalarials (p

Suggested Citation

  • Jessica Cohen & Günther Fink & Katrina Berg & Flavia Aber & Matthew Jordan & Kathleen Maloney & William Dickens, 2012. "Feasibility of Distributing Rapid Diagnostic Tests for Malaria in the Retail Sector: Evidence from an Implementation Study in Uganda," PLOS ONE, Public Library of Science, vol. 7(11), pages 1-10, November.
    • Handle: RePEc:plo:pone00:0048296
    DOI: 10.1371/journal.pone.0048296
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    References listed on IDEAS

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    1. Beth P Kangwana & Sarah V Kedenge & Abdisalan M Noor & Victor A Alegana & Andrew J Nyandigisi & Jayesh Pandit & Greg W Fegan & James E Todd & Simon Brooker & Robert W Snow & Catherine A Goodman, 2011. "The Impact of Retail-Sector Delivery of Artemether–Lumefantrine on Malaria Treatment of Children under Five in Kenya: A Cluster Randomized Controlled Trial," PLOS Medicine, Public Library of Science, vol. 8(5), pages 1-14, May.
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    Cited by:

    1. Chinwoke Isiguzo & Jennifer Anyanti & Chinazo Ujuju & Ernest Nwokolo & Anna De La Cruz & Eric Schatzkin & Sepideh Modrek & Dominic Montagu & Jenny Liu, 2014. "Presumptive Treatment of Malaria from Formal and Informal Drug Vendors in Nigeria," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-14, October.
    2. 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 Coh, 2017. "Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-24, March.

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