Malaria is a major problem in Kenya. It accounts for 30% of all outpatient attendance and 19% of all admissions to our health facilities and 3-5% inpatient mortality. An estimated 170 million working days are lost to the disease each year.
Laboratory confirmation of malaria infection is an essential component of fever case management, and should be provided at all levels of health care to ensure correct patient management, and minimise the use and cost of anti-malarial treatment drugs.
Many countries in sub-Saharan Africa support the Roll Back Malaria (RBM) and Millennium Development Goals strategies that aim to reduce the malaria burden by half by the year 2010 and 2015 respectively and to achieve these goals countries must adopt policies and practices that improve the quality of laboratory diagnosis of malaria. Improved quality of laboratory diagnosis of malaria will retain the confidence of clinicians in laboratory results, leading to improved management of malaria infections.
AMREF and partners have been implementing malaria diagnosis in the thirteen countries in Africa identified by presidents Malaria Initiative (PMI) namely: Liberia, Ghana, Mali, Benin, Nigeria, DRC, Burundi, Kenya, Ethiopia, Malawi, Zambia, Madagascar and Angola.
IMaD Mandate
- Technical training;
- Regular mentoring and monitoring of laboratory and clinical staff
- Enhancement of quality assurance systems
- Development of policy guidelines and implementation strategies
- Laboratory services for diagnosing infections and monitoring treatment.
Achievements to Date
- A comprehensive laboratory needs assessment completed in all countries
- Malaria microscopy refresher training (MMRT) successfully done in 10 countries
- Outreach training and support supervision (OTSS) launched in 7 countries
- Supported 38 participants to attend malaria microscopy accreditation (MMAC) from 6 countries
- Developed supervisory checklist for clinicians and laboratory staff
- Developed a grading template for grading MMRT and MMAC
Lessons Learnt
- It is possible to standardize malaria diagnostics across regions including countries emerging from war
- In country presence is important for implementation of activities
- Institutional support is important in implementation of activities
- Peripheral laboratories, even in remote or under-resourced areas, can provide high quality testing
- Onsite training and support supervision improves utilisation of Laboratory test results in making clinical decisions
