The use of Fionet technology for external quality control of malaria rapid diagnostic tests and monitoring health workers’ performance in rural military health facilities in Tanzania

• DOI: 10.1371/journal.pone.0208583
• Publication Date: 2018-12-27T21:07:12Z
• Authors: Akili K. Kalinga; Deus S. Ishengoma; Reginald Kavishe; Lucky Temu; Christopher Mswanya; Charles Mwanziva; Erick J. Mgina; Sarah Chiduo; Lucas Mahikwano; Saidi Mgata; Lalaine Anova; George Amoo; Eyako Wurapa; Brian Vesely; Edwin Kamau; Mark Hickman; Norman Waters; Mara Kreishman-De...; Robert Paris; Colin Ohrt
• Keywords: Rapid diagnostic test; Visual inspection

Internal and external quality control (QC) of rapid diagnostic tests (RDTs) is important to increase reliability RDTs currently used diagnose malaria. However, cross-checking as part assurance can rarely be done by off-site personnel because there no guarantee retaining visible test lines after manufacturers' recommended reading time. Therefore, this study examined the potential using Fionet™ technology for remote RDT monitoring at seven clinics, identifying reasons making processing interpretation errors, taking corrective actions improvement diagnosis consequently improved management febrile patients.The was conducted military health facilities in Mainland Tanzania utilized capable detecting Plasmodium falciparum specific Histidine-rich protein 2 (Pf-HRP2) genus lactate dehydrogenase (pLDH) other species plasmodium (P. vivax, P. malariae or ovale; pan-pLDH). Patients' data images processed from clinics were uploaded on a Fionet web portal reviewed regularly monitor preparation procedures visual results compared automated analysis Deki reader RDT. Problems detected rapidly communicated laboratory clinic action follow-up patients who falsely diagnosed negative missed treatment. Factors contributing errors analyzed during visits facilities.A total 1,367 (1.6%) out 83,294 had discordant which 822 (60.1%) 545 (39.9%) reported positive, respectively. False false positive common single line 515 (62.7%) 741 (54.2%) tests, Out assessed, 98 (7.2%) problems related 95(96.9%) due putting too much blood sample well insufficient buffer respective wells. The discrepant included, reporting none existent 526 (38.5%) missing faint 493 (36.1%), strong 248(18.1%) caused poorly 96 tests. Among (n = 822), 669 (48.9%) eligible only 339 (48.5%) reached 291 (85.8%) received appropriate anti-malaria therapy.Fionet enabled issues, provided method implement sites improve malaria care infected with