NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Thursday, March 19, 2015

A trial that trained Ugandan shopkeepers to use subsidised malaria test kits could point to a way of reducing the misuse of malaria medicine.

In many poor nations, people often seek treatment for malaria at drug shops, but “a big problem is that most private sector outlets don’t offer diagnoses”, says lead author Jessica Cohen, a global health researcher at the Harvard T. H. Chan School of Public Health, United States.

Fever is a well-known symptom of malaria, so people with a temperature in countries where malaria is endemic often assume this is the cause and buy antimalarial drugs. Because several other diseases cause this symptom, this practice wastes valuable doses of artemisinin combination therapies, the front-line treatment for malaria.

“Better diagnosis can help, so scaling up diagnosis in the place where most people buy medicines makes sense,” explains Cohen.

The study, published on 20 January in the Bulletin of the WHO, took place in 79 villages in Uganda. The researchers trained drug shop staff in these villages in using malaria diagnostic kits and offered them subsidised kits.

According to the results, having rapid diagnostic tests available at local drug shops roughly doubled the number of patients who bought them and had the staff test them from about nine per cent before the intervention to 17.5 per cent afterwards.*