Incorporating user needs into product development for improved infection detection for malaria elimination programs

In malaria-eliminating regions, a large proportion of ongoing transmission is attributed to low-density and subclinical infections that cannot be readily detected by currently available diagnostic tools. Accordingly, passive case detection strategies that dominate the focus of control programs need to be augmented by active infection detection (ID) tactics and more accurate diagnostic tools in an elimination context. To address this need, we are developing a target product profile (TPP) for a diagnostic test intended for use in active ID settings. To ensure the TPP incorporates the needs of users and the contexts in which active ID is implemented, we conducted field research in five representative countries across the spectrum of regional programs ranging from control to elimination. Using ethnographic interviewing, we gained an understanding of the contexts in which the test will be used and the constraints users encounter in successfully conducting active ID efforts. These findings inform the TPP and provide insight into operational conditions that must be addressed in parallel to product development. The results provide clear guidance for programmatic and technical initiatives, ensuring development and validation of innovative tools and tactics aimed at supporting successful elimination campaigns are well grounded in the needs identified by users.