title: Exploring health practitioners' acceptability of a prospective semi-quantitative pfHRP2 device to define severe malaria in the Democratic Republic of Congo.
abstract: BACKGROUND
  A rapid diagnostic tool is being developed to discern severely ill children with severe malaria from children who are ill with alternative febrile diseases but have coincidental peripheral blood parasitaemia. The device semi-quantitatively measures plasma pfHRP2 and has the potential to reduce mortality in children with severe febrile illnesses by improving diagnosis. The aim of this study is to identify contributing and inhibiting factors that affect healthcare practitioners' acceptability of this prospective diagnostic device in a high malaria transmission setting in the Democratic Republic of Congo.
  
  
  METHODS
  Data were collected qualitatively by conducting semi-structured interviews with a purposeful sample of health professionals in Kinshasa, capital of Democratic Republic of Congo. In total, 11 interviews were held with professionals at four different institutes.
  
  
  RESULTS
  Four key findings emerged: (1) Congolese practitioners perceive the semi-quantitative pfHRP2 device as a welcome intervention as they recognize the limited reliability of their current diagnostic and therapeutic approaches to severe febrile illnesses; (2) compatibility of the semi-quantitative pfHRP2 device with clinical equipment and competences of Congolese health practitioners is considered to be limited, especially in rural settings; (3) a formal training programme is crucial for correct understanding and application of the semi-quantitative pfHRP2 device; and, (4) provision of evidence to practitioners, and support from health authorities would be important to establish confidence in the semi-quantitative pfHRP2 device.
  
  
  CONCLUSIONS
  Congolese practitioners perceive the prospective semi-quantitative pfHRP2 device as a welcome addition to their clinical equipment. The device could improve current diagnostic work-up of severe febrile illness, which might consequently improve treatment choices. However, despite this recognized potential, several hurdles and drivers need to be taken into account when implementing this device in DR Congo.
authors.affiliation: Innovation Studies Group, Copernicus Institute, Utrecht University, Utrecht, The Netherlands. fdehaan12@gmail.com.
authors.forename: Freek
authors.initials: F
authors.lastname: de Haan
authors.affiliation: Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo. akatshimarie@yahoo.fr.
authors.forename: Marie A
authors.initials: MA
authors.lastname: Onyamboko
authors.affiliation: Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK. caterina@tropmedres.ac.|Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. caterina@tropmedres.ac.
authors.forename: Caterina I
authors.initials: CI
authors.lastname: Fanello
authors.affiliation: Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK. charlie@tropmedres.ac.|Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. charlie@tropmedres.ac.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Woodrow
authors.affiliation: Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK. yoel@tropmedres.ac.|Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. yoel@tropmedres.ac.
authors.forename: Yoel
authors.initials: Y
authors.lastname: Lubell
authors.affiliation: Innovation Studies Group, Copernicus Institute, Utrecht University, Utrecht, The Netherlands. w.p.c.boon@uu.nl.
authors.forename: Wouter P C
authors.initials: WP
authors.lastname: Boon
authors.affiliation: Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK. arjen@tropmedres.ac.|Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. arjen@tropmedres.ac.
authors.forename: Arjen M
authors.initials: AM
authors.lastname: Dondorp
mesh_terms: D000953:Antigens, Protozoan / Q000097:blood*; D001291:Attitude of Health Personnel; D002675:Child, Preschool; D015023:Democratic Republic of the Congo; D003937:Diagnosis, Differential; D003955:Diagnostic Tests, Routine / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D016778:Malaria, Falciparum / Q000175:diagnosis*; D010342:Patient Acceptance of Health Care; D015800:Protozoan Proteins / Q000097:blood*
chemical_list: D000953:Antigens, Protozoan; C514457:HRP-2 antigen, Plasmodium falciparum; D015800:Protozoan Proteins