OVERVIEW
Afghanistan has the fourth highest malaria rate of any country outside of sub-Saharan Africa and the second highest rate in the World Health Organization’s Eastern Mediterranean Region.  The number of clinical cases, those presenting with symptoms, is very high in Afghanistan.  However, laboratory confirmation of malaria diagnosis has been limited.

USAID aims to ensure proper diagnosis of malaria and to work towards the elimination of one organism that causes the disease, Plasmodium falciparum (Pf).  Operational in four high-risk provinces, Badakhshan, Baghlan, Kunduz, and Takhar, this project strengthens malaria laboratory diagnosis capabilities.  

ACTIVITIES

• Laboratory services in basic health centers – Establishing 71 labs in Badakhshan, Baghlan, Kunduz, and Takhar provinces to diagnose malaria cases
• Pilot rapid diagnostic testing (RDT) for malaria – Introduce testing that quickly detects the presence of malaria parasites in human blood (community health workers, local residents trained to administer basic healthcare in areas that lack doctors, provide testing in more than 100 health posts)
• Engage communities – Pilot rapid diagnostic testing with community health workers to engage remote communities, especially those with children less than five years of age and pregnant women, to confirm malaria diagnosis and initiate prompt and effective treatment
• Strengthen quality assurance – Introduce a comprehensive supervision plan for the basic health center laboratories to ensure proper malaria diagnosis and correct on-the-job errors

RESULTS

• Provided laboratory equipment, furniture, and supplies for 71 laboratories in basic health centers and developed a functioning laboratory network
• Provided RDT kits to more than 150 health posts and trained 29 community health supervisors and 297 community health workers on rapid diagnostic testing and supervision techniques
• Trained 71 laboratory microscopists in basic malaria microscopy
• Rehabilitated the training hall and established IT infrastructure for the National Malaria Leishmaniasis Control Program in Kabul.
• Confirmed reported malaria cases from primary health facility labs and community health posts
• Monitored and evaluated diagnostic testing from labs and health posts to ensure quality