Faster Diagnosis Leads to Faster Treatment
Mbale Provincial Rural Health Training Center in Western Kenya receives about 120 outpatient cases per day with 41% of the people requiring treatment for malaria. The Center provides various medical services at a subsidized rate. Thanks to the US President's Malaria Initiative, malaria treatment is free.
According to Dr. Jacob Odipo, who is in charge of the facility, all children under five receive free mosquito nets. Yet malaria infection in children remains high and is most likely attributed to mosquito bites received before children go to bed. Around 11:00 a.m. each day, mothers start streaming into the hospital. One mother has brought her one-year-old son, Vitor, to the hospital for a routine immunization. She is also concerned about his lack of appetite and high fever. The nurses recommended that Victor be tested for malaria. Thanks to the malaria rapid diagnostic test (RDT) kit, Victor’s test results come out in just half an hour. His results show he has malaria and he is immediately started on first-line treatment.
Three months ago, Victor’s mother would have had to wait for three to four hours to receive results and treatment. “Previously we used to rely 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. We suspect an unknown number were self-medicating for malaria to avoid the long lines,“ explains Mr. Odipo. The hospital 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 with only those who test positive for malaria receiving malaria medication,” said Dr. Odipo. The USAID Health Commodes and Services Management Program is implemented by Management Sciences for Health (MSH) in collaboration with Kenyan Division of Malaria Control (DOMC). The program is currently providing assistance to ensure that the rapdi diagnostic tests provided by the US President's Malaria Initiative, and other malaria commodities, are managed appropriately at the facility level. The program achieves this by training 3,200 frontline health workers on the use of RDTs in lower level facilities countrywide.
RDTs are a much needed intervention that represents benefits across all areas of the healthcare delivery system. Correct diagnosis saves the government or the patient $4.00 in unnecessary treatment costs in cases where there is no malaria infestion. The RTD kit costs $1.00 while the unsubsidized retail cost for Artemisinin/Lumefantrine (AL) 24s used for malaria treatment is approximately $5.00. The management of malaria in children under age five has previously been based on the clinical symptoms in malaria endemic zones. However, the Kenyan government recently adopted a universal diagnostic policy to ensure malaria is present before administering malaria treatment. To support this progressive policy, the US Government and other development partners have procured approximately eighty million RDTs for distribution and use in 2013.