Quicker Malaria Diagnosis Leads to Faster, Pin-Pointed Treatment in Kenya

Baby Victor and his mother. {Photo credit: Y. Otieno, MSH/Kenya}Photo credit: Y. Otieno, MSH/Kenya

Around 11 in the morning, mothers start streaming into the health facility. Baby Victor’s mother has brought him today for a routine immunization, but she’s also concerned about his lack of appetite and high fever. The nurses recommend that one-year-old Victor be tested for malaria.

Thanks to a malaria rapid diagnostic test (RDT) kit, Victor’s test results come back in just half an hour. He is positive for malaria and is started immediately on first-line treatment.

Three months ago, Victor’s mother would have had to wait hours to receive those results and treatment.

Mbale Provincial Rural Health Training Centre in Western Kenya receives about 120 outpatient cases, such as baby Victor's, per day; typically about 41 percent of them are treated for malaria. Although the Centre provides various medical services at a subsidized rate, malaria treatment is free. 

According to Dr. Jacob Odipo, who is in charge of the facility, all children under five also receive free mosquito nets. Still, malaria infection in children remains high, most likely because of mosquito bites the children receive before going to bed. 

“Previously, we relied on microscopy for malaria testing, and with the limited number of lab technicians, patients would have to wait for three to four hours for their results. Some left before receiving test results because of the long distances they would have to travel back home,” explains Dr. Odipo. “We suspect, too, that an unknown number were self-medicating for malaria to avoid the long lines.” 

The Centre has only one lab technician performing an average of 200 lab tests per day.

“Malaria RDT kits have helped ease congestion in the labs and help patients receive treatment faster—plus now, only those who test positive for malaria receive malaria medication,” Dr. Odipo pointed out.

A much-needed intervention, RDTs reap benefits across all areas of the health care delivery system, including costs. Correct diagnosis saves, for example, 80 percent in unnecessary treatment expenses for a negative result. The kit costs 1 USD; the unsubsidized retail cost for the medication used to treat malaria—artemisinin/lumefantrine (AL) 24s—is approximately 5 USD. 

Before now, the management of malaria has been based on the clinical symptoms of a patient under age five in malaria endemic zones, but the Kenyan government recently adopted a universal diagnostic policy to successfully provide universal malaria treatment. This led to the procurement of approximately 80 million RDTs for distribution and use in 2012 through the help of development partners.

Through funding from the President's Malaria Initiative (PMI), the USAID-funded, MSH-led Health Commodities and Services Management (HCSM) Program in collaboration with the Kenyan Division of Malaria Control (DOMC) currently provides assistance to ensure that the procured RDTs and other malaria commodities are managed appropriately. HCSM and DOMC are training 3,200 frontline health workers on the use of RDTs in lower level facilities countrywide.