Evaluation of Malaria Rapid Diagnostic Test Utilisation and Quality Assurance in Primary Healthcare Facilities in Kano State, North West Nigeria

Malaria rapid diagnostic tests have been widely distributed to primary healthcare facilities in Nigeria to promote parasitological confirmation before treatment, yet inconsistent quality assurance practices undermine diagnostic accuracy and appropriate case management. This study evaluates the utilisation patterns and quality assurance of malaria RDTs in primary healthcare facilities in Kano State, North West Nigeria. A mixed-methods cross-sectional design was employed, targeting 40 primary healthcare facilities across Kano Municipal, Ungogo, and Kumbotso Local Government Areas. Data were collected through facility audits, observation of RDT performance procedures, review of laboratory registers, and structured interviews with healthcare workers. Key quality assurance domains assessed included cold chain compliance, lot testing records, expiry date monitoring, and concordance of RDT results with clinical diagnoses. Current literature from 2020 to 2024 documents frequent quality lapses in RDT use at Nigerian PHC facilities, including improper storage, use of expired tests, and failure to follow manufacturer instructions. This study generates a quality assurance scorecard for participating facilities and identifies facility and workforce factors associated with poor RDT performance. Recommendations will be directed at the Kano State Ministry of Health and the National Malaria Elimination Programme for strengthening healthcare worker training and supply chain management. Findings will contribute to evidence-based revision of the national malaria diagnostics guidelines. Keywords: malaria RDT, quality assurance, primary healthcare, Kano State, diagnostics.