Malaria Control and Elimination - Malaria Diagnostics


MCDI has worked extensively in malaria diagnostics under the Improving Malaria Diagnostics Project (IMaD, 2007-2012), the President’s Malaria Initiative/USAID-funded MalariaCare project (2012-2017), and the recently awarded IMPACT Malaria project (2018-2023) but MCDI's expertise also extends to all of its projects combatting malaria.

Setting Global Standards

MCDI's technical experts contribute to the development of major guides on malaria diagnostics, including the WHO Universal Access to Malaria Diagnostic Testing Manual, the WHO Malaria Microscopy Quality Assurance Manual and the FIND RDT Implementation Guide. During a WHO meeting in Geneva, the OTSS model developed under iMaD was proposed as an effective way to carry out supervision and mentorship in WHO regional offices. This experience in setting global standards allows MCDI to effectively provide technical assistance to ministries of health and partners.

Development and Implementation of National Policy Guidelines

Using the WHO guideline documents as a framework, MCDI routinely works with host country National Malaria Control Programs (NMCPs) to align national malaria policy guidelines with WHO standards. Under the IMaD and MalariaCare projects, MCDI and our partners successfully assisted the Ministries of Health (MOH) in seven countries to develop national guidelines for the laboratory diagnosis and quality assurance of malaria.

Outreach Training and Support Supervision (OTSS)

The IMaD project developed and implemented a quality assurance cycle based on OTSS visits and lessons learned workshops. OTSS visits, conducted in public and private health facilities by trained supervisors, include data collection, observation, and mentoring. Strengthening or capacity building activities were programmed to support OTSS findings and fit into the overall External Quality Assurance (EQA) plan specific for each country. Under IMaD and under MalariaCare, MCDI performed over 8,000 OTSS visits. The ARM3 malaria project in Benin also uses OTSS.

Malaria Diagnostics Refresher Training Courses (MDRT)

Through IMaD and MalariaCare, MCDI has introduced the first competency-based curricula for laboratory staff performing malaria microscopy and rapid diagnostic tests (RDTs) to 14 countries. This enables ministries of health to assess health worker competencies against internationally recognized minimum standards for malaria microscopy. The course, MDRT, combines instructive sessions with daily practice and competency assessments. The StopPalu+ project in Guinea and MCDI's projects in Equatorial Guinea also use similar competency based training.

Rapid Diagnostics Tests (RDT) Roll Out Plans, Training and Quality Control

After the World Health Organization’s call for universal access to malaria diagnostic testing, MCDI assisted NMCPs in three countries to develop and implement RDT roll-out plans at the national, sub-national, district and private sector levels, including in Guinea through the StopPalu+ project. MCDI continues to train health workers on RDT use, interpretation and quality assurance at all levels of the health care system. Under our ARM3 project in Benin, MCDI conducted testing with the CDC of a potential solution for direct quality control of RDTs in the field. In MCDI's integrated health project in Nyagana Province, Gabon, health workers at local health facilities will be trained in RDT use.

Slide Banking

In Equatorial Guinea under the Bioko Island Malaria Control Project, MCDI developed a WHO-compliant malaria slide archive in order to support competency testing and quality improvement of microscopists. This slide archive was the first national slide bank in Africa that conformed to WHO requirements. During IMaD, MCDI assisted the Ministries of Health in Ghana and Ethiopia to develop national slide banks as well. The standard operation procedures for these banks formed the bases for the WHO-recommended SOPs for slide banking and validation. MCDI continues to lead slide bank development in several other countries.