title: Malaria rapid diagnostic test transport and storage conditions in Burkina Faso, Senegal, Ethiopia and the Philippines.
abstract: BACKGROUND
  As more point of care diagnostics become available, the need to transport and store perishable medical commodities to remote locations increases. As with other diagnostics, malaria rapid diagnostic tests (RDTs) must be highly reliable at point of use, but exposure to adverse environmental conditions during distribution has the potential to degrade tests and accuracy. In remote locations, poor quality diagnostics and drugs may have significant negative health impact that is not readily detectable by routine monitoring. This study assessed temperature and humidity throughout supply chains used to transport and store health commodities, such as RDTs.
  
  
  METHODS
  Monitoring devices capable of recording temperature and humidity were deployed to Burkina Faso (8), Senegal (10), Ethiopia (13) and the Philippines (6) over a 13-month period. The devices travelled through government supply chains, usually alongside RDTs, to health facilities where RDTs are stored, distributed and used. The recording period spanned just over a year, in order to avoid any biases related to seasonal temperature variations.
  
  
  RESULTS
  In the four countries, storage and transport temperatures regularly exceeded 30.0°C; maximum humidity level recorded was above 94% for the four countries. In three of the four countries, temperatures recorded at central storage facilities exceeded pharmaceutical storage standards for over 20% of the time, in another case for a majority of the time; and sometimes exceeded storage temperatures at peripheral sites.
  
  
  CONCLUSIONS
  Malaria RDTs were regularly exposed to temperatures above recommended limits for many commercially-available RDTs and other medical commodities such as drugs, but rarely exceeded the recommended storage limits for particular products in use in these countries. The results underline the need to select RDTs, and other commodities, according to expected field conditions, actively manage the environmental conditions in supply chains in tropical and sub-tropical climates. This would benefit from a re-visit of current global standards on stability of medical commodities based in tropical and sub-tropical climatic zones.
authors.affiliation: Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland. audrey.albertini@finddiagnostics.org
authors.forename: Audrey
authors.initials: A
authors.lastname: Albertini
authors.forename: Evan
authors.initials: E
authors.lastname: Lee
authors.forename: Sheick Oumar
authors.initials: SO
authors.lastname: Coulibaly
authors.forename: Markos
authors.initials: M
authors.lastname: Sleshi
authors.forename: Babacar
authors.initials: B
authors.lastname: Faye
authors.forename: Mary Lorraine
authors.initials: ML
authors.lastname: Mationg
authors.forename: Kadi
authors.initials: K
authors.lastname: Ouedraogo
authors.forename: Abeba G
authors.initials: AG
authors.lastname: Tsadik
authors.forename: Sendeaw Maksha
authors.initials: SM
authors.lastname: Feleke
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Diallo
authors.forename: Oumar
authors.initials: O
authors.lastname: Gaye
authors.forename: Jennifer
authors.initials: J
authors.lastname: Luchavez
authors.forename: Jessica
authors.initials: J
authors.lastname: Bennett
authors.forename: David
authors.initials: D
authors.lastname: Bell
mesh_terms: D002050:Burkina Faso; D002980:Climate; D004356:Drug Storage / Q000592:standards; D005002:Ethiopia; D006801:Humans; D006813:Humidity; D008288:Malaria / Q000175:diagnosis*; D010679:Philippines; D019095:Point-of-Care Systems / Q000592:standards / Q000706:statistics & numerical data; D011933:Reagent Kits, Diagnostic / Q000592:standards / Q000706:statistics & numerical data; D019035:Rural Health Services; D012675:Senegal; D013696:Temperature
chemical_list: D011933:Reagent Kits, Diagnostic