An Analytical Study of Malaria Rapid Diagnostic Test Uptake and Treatment Outcomes in Plateau State

Expanding rapid diagnostic test use for malaria diagnosis before treatment is a cornerstone of national malaria elimination strategy, yet its adoption at PHC level and its relationship with treatment outcomes in North Central Nigeria requires analytical documentation. This study analytically examined RDT uptake for malaria diagnosis and its association with appropriate treatment and clinical outcomes at PHC facilities in Plateau State. A retrospective facility-based cohort study was conducted using routinely collected malaria case management data from DHIS2 for 24 PHCs in Jos North, Mangu, and Shendam LGAs over a 24-month period (2022 to 2023). A total of 4,680 malaria encounter records were extracted and analysed. Encounters were classified by diagnostic pathway (RDT, microscopy, clinical diagnosis only) and linked to treatment appropriateness and return-visit outcome records. Logistic regression was applied. Results showed that RDT use occurred in 58.3 percent of encounters, with clinical diagnosis alone used in 32.6 percent. ACT prescription rate was significantly higher among RDT-confirmed positive cases than clinically diagnosed cases (91.4 percent versus 67.8 percent; p < 0.001). Among RDT-negative cases, ACT prescription still occurred in 41.2 percent, indicating incomplete clinician trust in negative results. Treatment failure or non-resolution at seven-day follow-up was significantly lower in RDT-confirmed treated cases. The study recommends clinician RDT counselling training, performance feedback systems, and RDT result documentation quality improvement in Plateau State PHC facilities. Keywords: malaria rapid diagnostic test, treatment outcomes, Plateau State, PHC malaria management, North Central Nigeria