Malaria testing rates at health facilities were high, reaching 94% in Bugesera, 90% in Gasabo, and 85% in Rwamagana. However, treatment completion gaps raise serious concern. Among confirmed positive cases, 28% in Bugesera, 26% in Gasabo, and 37% in Rwamagana were not treated at the point of care. A confirmed diagnosis without immediate treatment increases morbidity risk and allows continued transmission.
The findings reveal strong testing coverage, but critical weaknesses in diagnostic accuracy and treatment completion that demand urgent corrective action. Premature reading directly undermines diagnostic integrity and weakens surveillance data, which is essential for elimination planning.
Strict enforcement of the 15 minutes RDT waiting window must become non-negotiable, supported by supervision, spot checks, and performance monitoring. Diagnostic accuracy is the foundation of elimination. Yet quality gaps in diagnostic timing, treatment completion, and supply reliability threaten to slow elimination momentum.
Malaria Diagnosis at Risk: Rwanda Must Fix RDT Timing and Treatment Gaps Now to Protect Its 2030 Elimination Goal
In Gasabo, 57% of RDTs were read before the required 15 minutes waiting window, while 52% in Rwamagana and 45% in Bugesera were also read prematurely, that compromise the accuracy of malaria Rapid Diagnostic Test (RDT) readings. Reading RDTs too early compromises sensitivity and increases the risk of false negatives. False negatives allow ongoing transmission, delayed treatment, and potential progression to severe malaria.
The findings reveal strong testing coverage, but critical weaknesses in diagnostic accuracy and treatment completion that demand urgent corrective action. Premature reading directly undermines diagnostic integrity and weakens surveillance data, which is essential for elimination planning.
Strict enforcement of the 15 minutes RDT waiting window must become non-negotiable, supported by supervision, spot checks, and performance monitoring. Diagnostic accuracy is the foundation of elimination. Yet quality gaps in diagnostic timing, treatment completion, and supply reliability threaten to slow elimination momentum.
National malaria guidelines require strict buffer-and-wait timing to ensure diagnostic accuracy. Supervision systems must reinforce correct RDT timing, counselling quality, and compliance with national protocols. CHW supervision and mentorship must be strengthened to reinforce RDT timing compliance, clinical accuracy, and patient communication standards.