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Table 2 Interpretation and execution of RDTs by CHWs

From: Success or failure of critical steps in community case management of malaria with rapid diagnostic tests: a systematic review

Study CHW training Outcome interpretation Outcome execution
Counihan[18] Half-day training. At 3 months CHWs received a poster-sized job aid and a photographic guide on RDT interpretation. (I) RDT test results correctly read by 95.1, 98.3 and 98.3% of the CHWs at 3, 6 and 12 months after training respectively. 19-item checklist, interpretation included, 8 items were considered critical.
(II) Correct interpretation of positive RDT results was 96.5% at 3 months, 98.3% at 6 months and 90.5% at 12 months. Median correctly performed critical steps were 87.5%, 100% and 100% at 3, 6 and 12 months respectively.
(II) Correct interpretation of negative RDT results was 94.3% at 3 months, 97.9% at 6 months and 94.7% at 12 months. 40.3, 61.7 and 79.7% of CHWs correctly performed critical RDT steps at 3, 6 and 12 months respectively.
(II) Faint positive lines were correctly interpreted by 89.7% at 3 months, 96.7% at 6 months and declined to 76.7% at 12 months.  
Mukanga[32] 8-day training by experienced trainers. Job aid provided. 100% of the RDTs were correctly interpreted shortly after training (<2 weeks). 96.3% of RDTs were correctly performed shortly after training (<2 weeks) in a 14-item checklist, interpretation excluded.
Harvey[19] Group 1: only use of manufacturers’ instructions. Group 2: only use of job aid. Group 3: 3- hour training on RDTs + job aid. (I) 72, 86 and 96% of CHWs correctly interpreted RDT results for group 1, 2 and 3 respectively. 57% of steps, 80% of steps and 90% of steps were correctly performed by group 1, 2 and 3 respectively at the same day of receiving instructions, job aid or training in a 16-item checklist, interpretation included.
(II) 54, 82 and 93% of tests were correctly interpreted for group 1, 2 and 3 respectively.
Hawkes[21] One day training. Pictorial job aid was provided. 100% of CHWs correctly interpreted the RDT directly after training. Median score on a WHO 16-item assessment of RDT performance was 100% (range of 94-100%) directly after training.
Ndiaye[20] CHWs: one month theoretical training, one month practical training at health post. CMDs: 3-day theoretical training, 15 days practical training at health post. - % CHWs and CMDs correctly performing the step, observed over two years.
(1) Surface clean and flat - 87%
(2) Test opened just before use - 100%
(3) Document patient name and date - 83%
(4) Use of gloves - 0%
(5) 5 μL finger prick blood specimen - 93%
(6) 4 drops of solution buffer in right well - 93%
(7) test rest on level surface - 97%
(8) waited maximum 15 minutes - 93%
Mubi[24] One week training. 99.7% of positive tests were correctly interpreted throughout the 5-month study period. -
  1. (I) Based on assessment of RDTs.
  2. (II) Based on photographic assessment.