Case study: Medical technologies for combatting Malaria

Clinical and laboratory diagnosis of disease is key to adequate patient care. The choice of the best laboratory test must be based not only on the assessment of the test quality but also of the potential access and uptake from the target population. The test quality can be measured by its validity (specificity and sensitivity), precision and repeatability, altough its appropriateness is context dependent, as positive and negative predictive values vary with the population prevalence of disease. Access is also context dependent, as it varies with the availability of resources (logistic, staff, infrastracture, income), as well as uptake, which can be affected not only but the test invasiveness and safety but also on population attitudes and beliefs. The example of malaria will be used to describe how different laboratory tests are best suited at different levels of the health system (hospital, periphery, community) and disease prevalence (high, low) in resource-limited settings, and how frugal innovation could overcome some of the limits of the currently available tools.