Primary health workers' proficiency in using malaria rapid diagnostic tests in Limpopo Province.

To the Editor: Malaria rapid diagnostic tests (RDTs) have been used for the diagnosis of malaria in Limpopo Province since 2001. A key determinant of the effectiveness of malaria RDTs is end-user proficiency. Since this had not previously been assessed in the area, we undertook a cross-sectional survey among randomly selected end-users of RDTs at primary health care settings in January 2007. Only 9% of participants checked the expiry date of RDTs, 32% did not add the correct volume of buffer, 24% did not wait for at least 15 minutes before reading the test result, and 24% were unable to read the test correctly. The percentage of participants who correctly interpreted RDT positive results was 85% (177/200), and the percentage who correctly interpreted RDT negative results was 96% (24/25). To achieve the full potential of RDTs as a tool for diagnosis of malaria, end-user proficiency must be improved.