Case Management

Under BIMCP, MCDI managed the production of drug management protocols, training materials to support timely and proper treatment of malaria at all levels, inventory management systems, storage and distribution protocols, logistics management plans, and supervisory protocols for quality control of case management at health facility level. In addition, MCDI worked with the National Malaria Control Program (NMCP) and other partners to successfully introduce the use of artemisinin combination therapy (ACT) to replace chloroquine as the first line anti-malarial on Bioko Island. Data from sentinel survey sites in 2006 showed a reduction of 63% in malaria incidence among oil workers and a 69% reduction in malaria reported among children under the age of five. Health facility surveys demonstrated that over 90% of health providers were dispensing an effective anti-malarial at the correct dosage following the materials development and training. Finally, with support from the EGMCI project, MCDI provided technical assistance to the NMCP to plan for a roll out of a new ACT for first-line treatment throughout the country.

Under the President’s Malaria Initiative (PMI), in late 2007, MCDI was awarded a Cooperative Agreement as leader of a consortium to implement the Improving Malaria Diagnostics (IMaD) project. IMaD is a 5-year, $20 million program funded by USAID to cooperate with 15 Sub-Saharan African countries to improve laboratory-based diagnosis of malaria at primarily Ministry of Health facilities, and increase understanding, acceptance and use of rapid diagnostic tests (RDTs) by laboratory staff and health care practitioners providing direct care to patients. Regional activities in the Amazon basin and the Mekong delta may be included as well, if requested. Malaria treatment that is based on quality malaria diagnostics reduces mortality as well as costs, and minimizes the risk of developing drug resistance. Work began in ten PMI countries in 2008, and will expand into five more in future years.

Specific activities supported under IMaD include: 1) develop detailed plans for implementing, expanding, and improving laboratory-based diagnosis of malaria in Ministry of Health facilities; 2) assist with importation and in-country logistics of PMI commodities in selected countries; 3) develop training materials and train health workers in malaria diagnosis using microscopy/RDTs; 4) train health care providers and laboratory staff to implement national policies for diagnosis and treatment of malaria; 5) monitor stocks of supplies and develop a reporting and procurement system for their replacement; 6) develop a quality assurance plan for maintaining diagnostic quality over time; and 7) develop surge capacity to meet increased demand for diagnostic capabilities during malaria epidemics.