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Availability and price of malaria rapid diagnostic tests in the public and private health sectors in 2011: results from 10 nationally representative cross‐sectional retail surveys
Author(s) -
Poyer Stephen,
Shewchuk Tanya,
Tougher Sarah,
Ye Yazoume,
Mann Andrea G.,
Willey Barbara A.,
Thomson Rebecca,
Amuasi John H.,
Ren Ruilin,
Wamukoya Marilyn,
Taylor Mark,
Nguah Samuel Blay,
Mberu Blessing,
Kalolella Admirabilis,
Juma Elizabeth,
Festo Charles,
Johanes Boniface,
Diap Graciela,
Bruxvoort Katia,
Ansong Daniel,
Hanson Kara,
Arnold Fred,
Goodman Catherine
Publication year - 2015
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12491
Subject(s) - malaria , private sector , public sector , public health , rapid diagnostic test , audit , environmental health , medicine , health facility , business , cross sectional study , pharmacy , health care , family medicine , population , economic growth , health services , accounting , nursing , economics , economy , pathology , immunology
Objectives To describe the state of the public and private malaria diagnostics market shortly after WHO updated its guidelines for testing all suspected malaria cases prior to treatment. Methods Ten nationally representative cross‐sectional cluster surveys were conducted in 2011 among public and private health facilities, community health workers and retail outlets (pharmacies and drug shops) in nine countries ( T anzania mainland and Z anzibar surveyed separately). Eligible outlets had antimalarials in stock on the day of interview or had stocked antimalarials in the past 3 months. Results Three thousand four hundred and thirty‐nine rapid diagnostic test ( RDT ) products from 39 manufacturers were audited among 12 197 outlets interviewed. Availability was typically highest in public health facilities, although availability in these facilities varied greatly across countries, from 15% in N igeria to >90% in M adagascar and C ambodia. Private for‐profit sector availability was 46% in C ambodia, 20% in Z ambia, but low in other countries. Median retail prices for RDT s in the private for‐profit sector ranged from $0.00 in M adagascar to $3.13 in Z ambia. The reported number of RDT s used in the 7 days before the survey in public health facilities ranged from 3 ( B enin) to 50 ( Z ambia). Conclusions Eighteen months after WHO updated its case management guidelines, RDT availability remained poor in the private sector in sub‐ S aharan A frica. Given the ongoing importance of the private sector as a source of fever treatment, the goal of universal diagnosis will not be achievable under current circumstances. These results constitute national baselines against which progress in scaling‐up diagnostic tests can be assessed.