@article{fdi:010064785,
  title = {{A}ssessing drivers of full adoption of test and treat policy for malaria in {S}enegal},
  author = {{F}aust, {C}. and {Z}elner, {J}. and {B}rasseur, {P}hilippe and {V}aillant, {M}. and {B}adiane, {M}. and {C}isse, {M}. and {G}renfell, {B}. and {O}lliaro, {P}.},
  editor = {},
  language = {{ENG}},
  abstract = {{M}alaria treatment policy has changed from presumptive treatment to targeted "test and treat" ({T}&{T}) with malaria rapid diagnostic tests ({RDT}s) and artemisinin combination therapy ({ACT}). {T}his transition involves changing behavior among health providers, meaning delays between introduction and full implementation are recorded in almost every instance. {W}e investigated factors affecting successful transition, and suggest approaches for accelerating uptake of {T}&{T}. {R}ecords from 2000 to 2011 from health clinics in {S}enegal where malaria is mesoendemic were examined (96,166 cases). {T}he study period encompassed the implementation of national {T}&{T} policy in 2006. {A}nalysis showed that adherence to test results is the first indicator of {T}&{T} adoption and is dependent on accumulation of experience with positive {RDT}s (odds ratio [{OR}]: 0.55 [{P} <= 0.0011, 95% confidence interval [{CI}]: 0.53-0.58). {R}eliance on tests for malaria diagnosis (rather than presumptive diagnosis) followed after test adherence is achieved, and was also associated with increased experience with positive {RDT}s ({OR}: 0.60 [{P} <= 0.0011, 95% {CI}: 0.58-0.62). {L}ogistic models suggest that full adoption of {T}&{T} clinical practices can occur within 2 years, that monitoring these behavioral responses rather than {RDT} or {ACT} consumption will improve evaluation of {T}&{T} uptake, and that accelerating {T}&{T} uptake by focusing training on adherence to test results will reduce overdiagnosis and associated health and economic costs in mesoendemic regions.},
  keywords = {{SENEGAL}},
  booktitle = {},
  journal = {{A}merican {J}ournal of {T}ropical {M}edicine and {H}ygiene},
  volume = {93},
  numero = {1},
  pages = {159--167},
  ISSN = {0002-9637},
  year = {2015},
  DOI = {10.4269/ajtmh.14-0595},
  URL = {https://www.documentation.ird.fr/hor/fdi:010064785},
}