This July, HSL welcomed the World Health Organisation (WHO) malaria rapid diagnostic test (RDT) evaluation programme steering committee to the Halo. Professor Peter Chiodini, consultant speciality lead for parasitology at HSL, is a member of the international committee which oversees the technical and logistical aspects of the global evaluation programme. Chaired by Prof Chiodini, the two-day meeting saw the group of experts review the results of a recent round of RDT assessments and discuss future recommendations for RDT quality control (pre and post-purchase).
Malaria RDTs assist in the diagnosis of malaria by detecting antigens in human blood. They provide a rapid and reliable means of diagnosis particularly in areas with limited access to high quality microscopy services. “RDTs have greatly improved access to appropriate diagnosis and management of malaria,” explains Prof Chiodini. “They are relatively simple to perform and interpret, and require limited training. It means doctors in rural or remote areas have access to accurate diagnostic tests at the point of care and no longer have to treat patients for malaria based on symptoms alone.”
However, in the early stages of RDT roll-out, it became clear that there was significant variation in the quality and reliability of these point-of-care tests and regulation in endemic countries was often weak to non-existent. In response, WHO began to develop quality control (QC) procedures and, through a network of international laboratories in endemic and non-endemic countries, established a repository of well-characterized QC materials to conduct comparative performance evaluations of malaria RDTs. The outcome of these evaluations has been informing RDT procurement decisions at country and aid agency levels for several years. The Hospital for Tropical Diseases in London has been part of the international network and along with other institutions, has helped to create common performance standards against which malaria RDTs can be tested.
According to Prof Chiodini, the evaluation programme has had a “remarkable effect” on the quality of malaria RDTs used across the world. “Over the years accuracy and reliability have improved, and variation between batches has lessened. It’s a privilege to be part of a programme which has made significant improvements to the standards of malaria diagnostics, particularly in those areas which need it the most.”