WHO product testing round 3
WHO-FIND Malaria RDT Evaluation Programme
WHO, with the Foundation for Innovative New Diagnostics
(FIND), is coordinating the development of a global specimen
bank of cryo-preserved malaria parasite samples to support
product testing (comparative performance evaluation of
commercially-available antigen-detecting malaria rapid
diagnostic tests – RDTs). The second round of testing
commenced in April 2009 at the Malaria Branch, Division of
Parasitic Diseases, United States Centers for Disease Control
and Prevention (CDC) and results were reported in April 2010.
The expression for interest for Round 3 of the Product Testing
Programme was released in October 2010.
An outline of the testing programme (Methods manual for
product testing of malaria rapid diagnostic tests, v3) and
notices to manufacturers concerning round 3 of product testing
are outlined below.
This document compiles all the steps followed during this
process with all related letters, documents and supporting
materials.
For more information concerning the other rounds, please see:
Round 1 | Round 2 | Round 4 | Round 5
For more information on the WHO-FIND Malaria RDT Evaluation
Programme, please see:
http://www.who.int/malaria/areas/diagnosis/rapid-diagnostic-tests
19 October 2009 – Seeking expression of interest in participating in the WHO/TDRFIND malaria RDT product testing programme


1. Letter 1 to manufacturers
2. Attachments
Annex 1: General information on programme and timeline
Annex 2: Definition on production ‘lot’
Annex 3: Information on internal heat stability protocol
Appendix A: Expression of interest (EOI)
Appendix B: Material transfer agreement/confidentiality agreement (for
information only – do not fill out now)
Appendix C: Products to be included for evaluation (for information only –
do not fill out now)
Appendix D: Joint-submission or joint listing of products
10 December 2009 – Acceptance of EOI in WHO/TDR-FIND malaria RDT product
testing programme: Round 3


1. Letter 2 to manufacturers
2. Attachments
Annex 1: Order form; “Manufacturers’ panel” – culture-derived
P. falciparum samples
31 January 2010 – Acceptance of application into WHO/TDR-FIND malaria RDT
product testing programme: Round 3 and other information


1. Letter 3A to manufacturers
2. Attachments
Annex 1: Products to be included for evaluation
Annex 2: Order form; “Manufacturers’ panel” – culture-derived
P. falciparum samples
Annex 3: Information pack on manufacturing site stability testing
22 February 2010 – Confirmation of the final list of products for WHO/TDR-FIND
malaria RDT product testing programme: Round 3 and other information


1. Letter 3B to manufacturers
2. Attachments
Annex 1 (1): Availability of panels of cultured P. falciparum parasites for
preliminary testing of products by manufacturers (optional)
Annex 1 (2): Order form; “Manufacturers’ panel” – culture-derived
P. falciparum samples
Annex 2: Temperature monitor envelope and information needed
WHO product testing round 3 – WHO-FIND Malaria RDT Evaluation Programme (documentation archive) | 2
Annex 3: Information pack on manufacturing site stability testing
Annex 4: SOPs for transportation of products to US CDC
31 March 2010 – Deadline for shipment of RDTs to US CDC
4 May 2010 – Final list of products accepted into round 3 of WHO/TDR-FIND malaria
RDT product testing programme

Round 3 product summary list
29 August 2011 – Characteristics of evaluation panel used in round 3
11 October 2011 – Results of WHO malaria RDT product testing round 3 (2010-2011)




Malaria Rapid Diagnostic Test Performance – Results of WHO product testing of
malaria RDTs: Round 3 (2010–2011)
Malaria rapid diagnostic test performance : summary results of WHO malaria RDTs
product testing: rounds 1–3 [2008–2011]
Interactive RDT performance guide
Interactive programme to assist in the selection of malaria RDTs based on the
performance in the WHO product testing rounds 1–3, located on the FIND website
16 December 2011 – Performance des tests de diagnostic rapide du paludisme

Bilan des résultats d’évaluation des produits par l’OMS : Séries 1–3 (2008–2011)
20 December 2011

WHO information note on recommended selection criteria for procurement of malaria
rapid diagnostic tests (RDTs)
WHO product testing round 3 – WHO-FIND Malaria RDT Evaluation Programme (documentation archive) | 3
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
ANNEX 1
ROUND THREE OF WHO/TDR-FIND MALARIA RDT PRODUCT TESTING PROGRAMME
This document includes details of Round Three of WHO/TDR-FIND Malaria Rapid Diagnostic Test
(RDT) Product Testing Programme and criteria for inclusion of products.
The only action necessary at present for a manufacturer interested in participating in this Programme
is to send the details of the products considered for submission to WHO/TDR-FIND Round Three
Product Testing Programme, in accordance with the instructions described below. Such an
Expression of Interest will not be binding on either party, but must be received by FIND by
30 November 2009 to allow participation in the Third Round of testing (which is scheduled to
commence at the end of March of 2010).
A. Introduction
WHO is proposing to undertake this evaluation to assess the performance of antigen-detecting
malaria rapid diagnostic tests (RDT). All product testing will be conducted at the Malaria Branch,
Division of Parasitic Diseases, and Centers for Disease Control and Prevention, Atlanta, U.S.A. with
an additional stability assessment performed at the site of manufacturer. The Programme will be
coordinated jointly by the UNICEF/UNDP/World Bank/WHO Special Programme for Research and
Training in Tropical Diseases (WHO/TDR), and the Foundation for Innovative New Diagnostics
(FIND).
Testing will be conducted in two phases. A total of 2200 Malaria RDTs, consisting of
1100 tests from each of the two separate lots for each product, will be required to be
submitted for the Programme, Phase I of the testing process will be performed against a
panel of cryo-preserved preparations of cultured parasites and recombinant antigens. Phase II
will be performed against a panel containing diluted cryo-preserved preparations of wild
parasites, and parasite-negative samples. Manufacturers cover the courier cost and associated
costs of transport of RDTs to US CDC and the cost of transport of proficiency panels from CDC
to the site of manufacturer.
A subset of the product test panel prepared from cultured P. falciparum malaria parasites will be
made available to manufacturers for their own quality control testing prior to submission of products
to the Product Testing Programme (optional), and for a stability test at the manufacturing site
required later (mandatory) as part of the Product Testing Programme.
Submission of a request for inclusion of products (Expression of Interest, EOI) in the Third Round of
testing will close 30 November 2009. Only these products listed on the Appendix A will be eligible for
Round Three of the Product Testing Programme. WHO reserves the right to limit the number of
products per manufacturer if the total number of products in the EOI is beyond the capacity for testing
by the Programme in a single round of Product Testing.
As with the first and second rounds of Product Testing, Round Three of WHO/TDR-FIND
Malaria RDT Product Testing Programme the performance data will form the basis of
procurement recommendations of WHO and the WHO tendering programme. RDTs must be
submitted to the Product Testing Programme will be listed on the WHO web site.
Data on product performance during testing will be published by WHO/TDR-FIND as an addition to
the published results of each Round of Product Testing and will guide future procurement of RDTs by
WHO, other UN Agencies and national health authorities. Manufacturers will be informed of the
performance results, in accordance with the terms of the attached sample Confidentiality Agreement.
(The Confidentiality Agreement in APPENDIX B should not be signed at this stage, but will be
required at the time of final product submission for the WHO/TDR-FIND Product Testing Programme
– see diagram on page 6).
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WHO/TDR-FIND Malaria Product Testing Programme – Round 3
It is not necessary to re-submit a product to subsequent rounds for the product to remain
eligible for WHO procurement, or to have its performance listed on the WHO website.
However, a manufacturer may resubmit a product to subsequent rounds. Note that the results
of earlier rounds will be replaced in the performance report by results of subsequent rounds to
which the product is submitted.
WHO will list all products evaluated as part of the WHO/TDR-FIND Malaria RDT Product Testing
Programme together with their performance data on a dedicated page of the WHO website and in a
hard copy publication. WHO may remove a product from the website list or require re-submission of
a product for performance testing if changes in product specifications listed in ANNEX 2 indicate that
the RDT should be considered a new product, or performance data obtained from lot testing in the
field are considered to be consistently outside those of the product testing programme published by
WHO and/or FIND. The manufacturer of a listed product of which the product specifications have
been changed, is required to inform WHO and FIND of such changes prior to the commercial release
of the changed product. Publication of data on product performance and/or inclusion in the above
mentioned website list does not guarantee that the RDTs in question will actually be procured by
WHO or any other party.
Participation in the Product Testing Programme, publication by WHO/TDR-FIND of the testing results
and/or inclusion in the website list may not be used by the manufacturers and suppliers concerned
for commercial or promotional purposes. With respect to the manufacturers' or suppliers' participation
in the Product Testing Programme, under no circumstances is a manufacturer or supplier authorized
to refer to WHO and/or FIND, the publication of the testing results by WHO and/or FIND and/or
inclusion in the website list, in any statement or material of an advertising or promotional nature,
press release and/or similar public statement and/or other material aimed at promoting the
manufacturer or supplier and/or its products.
Furthermore, publication of the testing results and/or inclusion in the website list does not in any way
imply an endorsement, certification, warranty of fitness or recommendation by WHO or FIND of any
company or product for any purpose, and does not imply preference over products of a similar nature
that are not mentioned. Neither WHO or FIND will accept any liability or responsibility whatsoever for
any injury, death, loss, damage, or other prejudice of any kind that may arise as a result of, or in
connection with the procurement, distribution and use of any product, as to which WHO and/or FIND
has published the testing results and/or which is included on the list.
B. Criteria for entry to the Product Testing Programme
Conditions of entry are derived from the recommendations of WHO expert consultations at Geneva,
Kisumu and Atlanta in 2006.
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WHO/TDR-FIND Malaria Product Testing Programme – Round 3
Conditions for testing of products as part of the WHO/TDR-FIND Malaria Diagnostics Product
1
Testing Programme (see Diagram on page 6)
1.
By 30 November 2009: Submission of an Expression of Interest (EOI) to FIND (as in the
attached Appendix A).
Documents to be submitted by E-mail and hard copy to:
Julie Vercruysse
FIND
Foundation for Innovative New Diagnostics
16 Avenue de Budé
1202 Geneva
Switzerland
Tel: +41 (22) 710 05 97
Fax: +41 (22) 710 05 99
E-mail: [email protected]
With a copy to [email protected]
2.
By 15 January 2010 (if EOI is accepted): Fulfillments of the requirements for taking part in
Round 3 of Product Testing Programme including:
a) Current ISO 13485:2003 (By E-mail)
b) Provision of an acceptable heat stability protocol of internal quality assurance (ANNEX 3).
(By E-mail)
(Manufacturers who already fulfil these criteria and participated in the First Round of WHO
RDT
Product
Testing
and
included
in
the
WHO
RDT
website
(http://www.wpro.who.int/sites/rdt) under list of commercially available malaria RDTs, are not
required to submit further evidence concerning this).
c)
Submission of 2 original copies of the Confidentiality Agreement (APPENDIX B) and
acceptance of conditions for product testing and publication of results, including the
undertaking to perform a stability test of submitted product lots according to a protocol
specified by WHO-FIND and to submit the results thereof to WHO-FIND for publication2 (By
hard copy and E-mail)
c)
Final Product List (APPENDIX C) and product leaflets (By hard copy and E-mail)
3.
By End of March 2010: Free supply and delivery of Malaria RDTs to US CDC, Atlanta. (see
point E below)
4.
Re-labelled products that are manufactured at the same site and under the same conditions as a
tested product, and fulfills the criteria in APPENDIX D may be jointly listed with the tested
product under the criteria and conditions listed in APPENDIX D.
5.
The above actions should be undertaken if and when WHO or FIND so notifies the
manufacturer. No product testing will take place unless the manufacturer has fulfilled the above
conditions by the dates set by WHO and FIND and in accordance with WHO and FIND's
instructions.
1
It is planned to include a product specific audit as a criteria in the future, through a mechanism to be determined by WHO
The format of the stability test outlined in : WHO (2006) Towards Quality testing of malaria rapid diagnostic tests: Evidence and
methods, Manila, WHO
2
3
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
D. Supply of products for testing
•
A total of 2200 tests consisting of 1100 tests from each of the two separate lots must be
submitted for the Programme. .
•
All RDTs must be received at US CDC by a given deadline (not before middle of March 2010) in
order to be accepted for product testing. (Temperature monitors for the duration of the
transportation can be obtained from FIND free of charge at request)
•
All products will be stored in an air conditioned, temperature monitored room from the time of
receipt until the actual testing occurs (the product testing site will determine the order in which
testing will be conducted)
•
Sufficient product of each lot should be provided (as mentioned) to conduct both phases of
testing against the challenge panel (Towards quality testing of malaria rapid diagnostic tests:
Evidence and methods. Manila, World Health Organization, 2006). If a product does not display
sufficient performance against the Phase 1 panel, the lot will not be tested against the Phase 2
panel. Sufficient performance is defined as > 80% detection rate at 2000 parasites/µl.
Important note on RDT format
Manufacturers may submit products in any format and for any target antigen. RDTs with the same
product name but different format (e.g. cassette and dipstick) are considered as separate products
and will require separate submission and testing. On publication of the testing results by WHO-FIND,
the introductory text accompanying the table of product performance characteristics will emphasize
the current WHO recommendation that cassettes are preferred to dipsticks for field use in endemic
countries. Manufacturers are therefore advised to consider submitting only tests in cassette format.
It is noted that Rounds 1 and 2 of Product Testing (2007-2008) included few products targeting P.
falciparum specific pLDH. These products may have advantages in certain endemic settings and
therefore, we encourage manufacturers to seriously consider submission of such products.
E. Oversight: Specimen Bank Review Committee
The Malaria Specimen Bank (currently at US CDC), is the repository of characterized samples
against which product testing will occur, and includes recombinant antigen, culture-derived and wildtype malaria parasites, and negative samples. The wild-type parasites are collected from a
geographically-diverse network of collection sites in Asia, Africa and South America, and prepared
according to standard protocols.
A Specimen Bank Review Committee will oversee the technical and logistical aspects of the testing
and evaluation process, including the development of Standard Operating Procedures (SOPs),
oversight of ethical approval for the collection sites contributing to the Specimen Bank (including
submission to the WHO Ethics Committee, and local ethical review board) and oversight of the
product testing and reporting of results.
Terms of Reference of the Specimen Bank Review Committee:
The Malaria RDT Specimen Bank Review Committee will provide recommendations to WHO and
FIND on:
•
Development and modifications of SOPs for specimen collection and use
•
Accumulation and content of the Specimen Bank, and characterization and maintenance
•
Policy on access to the Specimen Bank
4
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
•
Protocols for laboratory-based testing of the accuracy and stability of malaria RDTs, including
product testing and lot testing
•
Interpretation of the results of product testing, prior to publication.
Composition
Core:
3
WHO/TDR [1 ],
Foundation for Innovative New Diagnostics (FIND), [3]
US Centers for Disease Control and Prevention (CDC), [2]
Médecins sans Frontières, [1]
Collection sites: 1 African, [1]
1 non-African, [1]
Specimen characterization centers:
Hospital for Tropical Disease, UK [1]
Army Malaria Institute, AU, [1]
3
Figure in brackets indicates the number of representatives.
5
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
WHO/TDR-FIND Malaria RDT Product Testing
Programme
Step 1: Submission of Expression of Interest (Appendix A)
Deadline for
Receipt
30 NOV 2009
Step 2:
FIND sends EOI Acceptance letter to manufacturers, final number
of tests per manufacturers that can be submitted to Round 3 and details for
obtaining the optional culture panel from CDC for manufacturer quality control
testing.
07 DEC 2009
Step 3:
Submission of ISO 13485:2003 and Provision of heat stability
protocol of internal quality assurance (If not already submitted previously),
TWO signed ORIGINAL copies of Confidentiality Agreements (APPENDIX B),
Final list of products (APPENDIX C), and Product inserts/leaflets for each
product submitted.
Request for Temperature monitor for duration of RDT transportation
(Optional)
Deadline for
Receipt
15 JAN 2010
Step 4: Review of the submissions by Steering committee
JAN 2010
Step 5:
JAN 2010
FIND sends Confirmation of acceptance of Final list of products for
the Product Testing Programme
each of two separate lots to US CDC
Deadline for
Receipt
END of MAR
2010
Step 7: Applicant obtaining parasite specimen samples from US CDC for
MAR/APR 2010
Step 6: Applicant submits a total of 2200 tests consisting of 1100 tests from
the stability testing at manufacturer site
Step 8: Applicant submits results of the stability test performed at the
manufacturer site every 3 monthly until the end of the specified shelf life
Step 9: Results of the Product Testing Programme at US CDC will be
available
February 2011
6
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
F. Further Information
Further information on the Product Testing Programme can be found in:
1.
Rapid Diagnostic Tests for Malaria: Methods Manual for Laboratory Quality Control Testing
Version 5, Aug 2008, Manila, World Health Organization – Regional Office for the Western
Pacific.
2.
WHO (2006B). Towards quality testing of malaria rapid diagnostic tests: Evidence and
methods, Manila, World Health Organization.
3.
Initiative for Quality Assurance of Malaria Rapid Diagnostic Tests: Outline of Product Testing
and associated protocols, 2007. (Product testing Overview)
4.
Methods Manual for Product Testing of Malaria Rapid Diagnostics Tests, Version 1 (Web
Version), April 2008, WHO.
All the above documents can be found at: http://www.wpro.who.int/sites/rdt/documents/list.htm
www.finddiagnostics.org and www.who.int/tdr or can be obtained by sending an email to: [email protected]
7
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
ANNEX 2
Definition of a 'Product' and 'Lot'
It is necessary to clearly define the terms “product” and “lot” to implement the proposed testing
scheme, as product testing results should be applied only to a specifically defined and labelled
product, and lot testing results should be applied only to a clearly defined and labelled lot.
(1) Lot. The definition of a “lot” is the responsibility of the manufacturer. All manufacturers must
have current ISO 13485:2003 or US FDA 21 CFR 820 certification and an appropriate “lot”
definition must be compatible with this.
(2) Product. Defining a malaria RDT “product” for the purposes of a product testing scheme is
more difficult. However, this definition should be based on consistency in overall design and
on the major constituents of the RDT that are likely to have a significant impact on RDT
stability and accuracy. Assuming that evidence of equivalent performance can be provided,
the following applies:
a)
Similar but re-labelled products from various manufacturers should generally be
considered different products (see joint listing of products below) but may be considered
the same product if specifically indicated by the manufacturers concerned.
b)
Monoclonal antibodies (Mab) – A change in target epitope, or of the species from which
target antigen for Mab development is derived, should constitute a new product. A
change in source (manufacturer) or modifying the amount of Mab used in a test would
not constitute a new product if the Mab cell line originated from the same source.
c)
Dye conjugate (signal reagent) – A change in specification or type of label (e.g. colloidal
gold, latex particle or liposome) should constitute a new product, but a change in
manufacturer/source should not.
d)
Format – A change in assay presentation between, for example, a dipstick, cassette or
card, constitutes a new product.
e)
Buffer – A change in assay buffer constituents or pH does not constitute a new product.
(3) Equivalence of performance. Where changes made have the potential to significantly affect
accuracy of the RDT, including changes in raw materials or components, including Mabs,
signal reagents, buffers, nitrocellulose membranes, or in cassette design, equivalence of
performance data should be provided to WHO-FIND to demonstrate that the modified product
has a performance equivalent to, or better than, that previously submitted to formal testing. As
this is an activity that should be performed as part of routine internal QA by the manufacturer,
demonstration and notification of equivalence should not result in additional costs or workload.
Reference:
1. Towards Quality Testing of Malaria RDT-Evidence and Methods, 2006, World Health Organization
8
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
ANNEX 3
Internal Heat Stability Protocol at manufacturing site
As evidence of stability testing, WHO-FIND will accept protocols submitted by manufacturers that comply
with the points listed below. By providing WHO-FIND with the required evidence of testing for product
storage temperature and shelf life, and confirmation that products have been tested according to these
protocols, the manufacturer automatically confirms that WHO-FIND shall be entitled to disclose such
evidence.
The following standards for stability testing are modified from Hornback, L.A., originally published in IVD
Technology, April 2004 (See references)
A stability study for in-vitro diagnostic device (IVD) reagents has the same elements as those
dictated for stability testing of drugs including the following:
•
A written stability testing programme designed to assess the stability characteristics of IVDs.
•
A stability protocol with predefined acceptance criteria that can be correlated to the label claims.
•
Testing multiple unique product lots. A stability study is required to use three product lots that
are manufactured when the manufacturing process has been well defined and can be
consistently executed.
•
Evaluation of each stability attribute via a statistically valid sample size and testing intervals.
The sample size should be sufficient to overcome the precision of the test method used,
considering the cumulative effect of all elements of the test system (i.e., individual reagents and
instruments). The test intervals should be chosen so that trends may be discerned from
variability of the data. At a minimum, stability testing should continue to one time interval past
labeled expiration.
•
Control of material storage. For real-time stability testing, the IVD reagents should be stored
under the conditions stated on the label (e.g., temperature, humidity, light protection).
•
Testing IVD in the same container-closure system as the marketed product.
•
Use of reliable, meaningful and specific test methods.
The requirement set forth in the last bullet point implies the use of blood samples containing
adequate parasite antigen to produce a clear test line on the RDT near the minimum equivalent
parasite density that the RDT is expected to detect.
Use of Accelerated Study Data
Accelerated stability studies are useful for predicting the shelf life of IVD. Such accelerated studies
subject IVD to extreme conditions—typically elevated temperatures—to the extent that the device
endures significant and measurable deterioration during the testing period. Mathematical extrapolations,
such as the Arrhenius equation, are then used to calculate the predicted shelf life of the IVD. However,
not all IVD follow a predictable degradation rate. Some products will perform acceptably until they fail, in
which case only real-time testing will suffice.
According to the United States Food and Drug Administration's Office of In Vitro Diagnostic Device
Evaluation and Safety, accelerated stability studies are acceptable in the following situations:
•
•
establishing preliminary claims in new products only if there is sufficient correlation to an existing
product and,
supporting implementation of a change to an existing product.
The European standard EN 13640:2000 provides guidance on not only conducting real-time and
accelerated stability studies but also making calculations using the Arrhenius equation. Only real-time
9
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
stability data are acceptable for testing of either newly licensed IVD or major changes to existing IVD, but
for purposes of malaria RDTs it is recognized by WHO that accelerated data, used with reference to
accelerated and real-time data from pre-existing products, is acceptable as an interim measure.
References
1. Hornback, L. A. Stability testing for IVDs. IVD Technology 10 (2004).
10
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
APPENDIX A:
Expression of Interest – Notification of interest to submit an antigen- detecting malaria rapid diagnostic test to the WHO/TDR-FIND Malaria RDT Product
Testing Programme
Company name
Product Name
Catalogue
Number
Plasmodium
species
1
targeted
Target antigen(s)
Format2
Dipstick: D
Cassette: Ca
Card: Cd
Packaging
(Individual or bulk).
Number
of tests
per box
All materials can be
included?
(lancets, swabs,
wells if required)
A
B
C
D
E
Product name
Shelf life
Storage temperature
recommended by
manufacturer
Temperature stability data on
which shelf-life is based
('Accelerated'
or 'Real time')
Contact person
(If appropriate)
Address
(for procuring tests)
Email
URL
Contact numbers
A
B
C
D
E
1.
P: falciparum, V: vivax, O: ovale, M: malariae, Pan: all. 2.'Dipstick' refers to simple nitrocellulose strip which requires placement in well. Cassette / card indicates strip enclosed in (plastic) cassette or card.
Signature_______________________ Name _____________________________ Designation / position _________________________
11
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
NOTES:
•
Please note that the information submitted on this form should be accurate for WHO-FIND publication purposes
•
This Expression of Interest should be submitted to Julie Vercruysse, 16 Avenue de Budé, 1202 Geneva, Switzerland, Email: [email protected],
with an e-copy to: [email protected], by 30 November 2008.
•
Manufacturers should ensure that receipt is acknowledged. The provision of the required product details in this table, and the provision of evidence demonstrating
compliance with the requirements set forth in Annex 1 point C, is necessary in order for the products to be considered by WHO for inclusion in the initial round of
Product Testing.
•
Only products listed above maybe included in the list of products finally submitted to the Product Testing Programme. WHO-FIND reserves the right to limit the
maximum number of products that can be submitted by manufacturers, if the listed products in the EOI is beyond the capacity for testing by the Programme in a single
round of Product Testing. Manufacturer will be notified accordingly.
•
If co-listing any product, Appendix D must also be completed and submitted with the EOI.
•
FIND will notify a manufacturer if and when products have been accepted for this round of Product Testing Programme.
•
The submission of an EOI and/or the aforesaid evidence will neither obligate WHO-FIND to accept, nor obligate the manufacturer to actually provide, the listed
products for product testing.
CHECKLIST for manufacturer before Submission of EOI
1. ISO 13485:2003 Certificate (can be submitted by 15 Jan 2010)
2. Heat Stability Protocol (can be submitted by 15 Jan 2010)
3. Completed and signed product specifics (Appendix A) – 30 Nov 2009
4. Completed and signed Co-listing details (if relevant) (Appendix D) - 30 Nov 2009
(signed by both the manufacturer and the owner of the product)
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WHO/TDR-FIND Malaria Product Testing Programme – Round 3
APPENDIX B
WHO STANDARD CONFIDENTIALITY AND
MATERIAL TRANSFER AGREEMENT
Between
.........................................................having its principal offices at......................................................................
.........................................................(hereinafter referred to as "the Company");
and
The World Health Organization, Avenue Appia, 1211 Geneva 27, Switzerland, (hereinafter referred to as
“WHO”).
The Company has developed (a) rapid malaria diagnostic test(s), known under the trademark ……,
which test(s) is/are further described in Exhibit 1 attached hereto, (hereinafter referred to as “the
Product(s)”, and information relating thereto (hereinafter referred as the “the Information”). WHO is
interested in having the Product(s) evaluated and tested in the WHO/TDR-FIND Malaria Rapid
Diagnostic Test (RDT) Product Testing Programme, jointly coordinated by the WHO, the
UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases
(WHO/TDR), and the Foundation for Innovative New Diagnostics (FIND) hereinafter referred to as
"WHO/TDR-FIND Malaria Rapid Diagnostic Test (RDT) Product Testing Programme".
Therefore, the Parties have agreed as follows:
(1)
The Company shall disclose and furnish to WHO the Information and sufficient quantities of the
Product(s) in order to enable WHO to assess the Information and arrange for such evaluations of
the Product(s), as WHO may determine, are reasonably necessary to assess the performance of
the Product(s) and its/their suitability for use at the primary health care settings in developing
countries. At the conclusion of the testing and evaluation process, WHO will report the results
thereof to the Company and, at the Company’s request and cost, return or destroy the
Information and any unused quantities of the Product(s).
For the avoidance of doubt,
"Information" as used herein does not include the data and information resulting from the testing
and evaluation process (including the stability test(s) performed by the Company and submitted
to WHO as part of the Product Testing Programme), any other testing results and the reports
generated as a result of this Agreement (all the foregoing hereinafter jointly referred to as "the
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WHO/TDR-FIND Malaria Product Testing Programme – Round 3
Testing Results"). Such Testing Results shall belong to WHO (subject always, however, to the
other provisions of this Agreement).
(2)
If and to the extent that the Information has been marked by the Company as "Confidential",
WHO shall treat such Information as confidential and proprietary for a period of five years after
disclosure to it. In this connection, WHO shall take all reasonable measures to ensure that the
Information in question is not used for any purpose other than the aforementioned evaluation
and testing activities and is not disclosed or provided to any person who is not bound by similar
obligations of confidentiality and restrictions on use as contained in this Agreement.
(3)
WHO shall not be bound by any obligation of confidentiality or restriction on use to the extent it is
clearly able to demonstrate that any part of the Information:
a)
was known to WHO prior to any disclosure by the Company to WHO; or
b)
was in the public domain at the time of disclosure by the Company to WHO; or
c)
becomes part of the public domain through no fault of WHO; or
d)
becomes available to WHO from a third party not in breach of any legal obligations of
confidentiality to the Company.
(4)
The Company undertakes to abide by similar obligations of confidentiality and restrictions on use
as contained in paragraphs 2 and 3 above with regard to the Testing Results (regardless of
whether or not such Testing Results have been marked as "confidential").
(5)
The provision of Product(s), Information, and Testing Results shall not in itself be construed as
conveying rights under any patents or other intellectual property which either Party may have or
may hereafter obtain.
(6)
Subject to the protection of each Party’s confidential information and the provisions of this
paragraph 6, Testing Results may be published by either Party. In order to avoid prejudicing
confidential information of the other Party, the submitting Party will transmit to the other Party for
its review, the material intended to be published at least 60 (sixty) working days before a
proposed publication is submitted to any editor, publisher, referee or meeting organizer. In the
absence of an objection by the other Party within the 60-day period concerning prejudice to its
confidential information, and provided that all other conditions of this paragraph 6 have been
met, the publication may proceed.
In connection with the foregoing, it is understood and agreed that notwithstanding any other
provisions in this Agreement, WHO shall be entitled to evaluate and publish the Testing Results,
and to exclusively control this evaluation and the content of the aforesaid publication, provided
that in order to avoid prejudice to the Company’s confidential Information disclosed to WHO
14
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
pursuant to paragraphs 1 and 2 above, WHO shall submit any proposed publication to the
Company for review in accordance with the provisions of paragraph 6. For the avoidance of any
doubt, the Company shall only be entitled to object to a proposed publication if and to the extent
it contains any confidential Information of the Company, and not on the grounds that the
Company is not satisfied with the Testing Results and/or does not agree with WHO's evaluation
thereof.
The Company shall not proceed to the publication (or any other public disclosure) of any of the
Testing Results until such Results have been published by WHO and until the proposed
publication has been submitted to WHO for review in accordance with the provisions of
paragraph 6.
All publications of the results of any evaluation and testing activities carried out under this
Agreement shall include the following statement:
“This investigation was carried out as part of the "WHO/TDR-FIND Malaria Rapid Diagnostic
Test (RDT) Product Testing Programme ".
Other than as provided herein before, neither Party shall, in any statement or material of an
advertising or promotional nature, refer to the relationship of the Parties under this Agreement or
to the relationship of the other Party to the Product(s). The Company shall not, at any time, use,
nor allow any other parties to use, the participation in the Product Testing Programme and/or
publication by WHO of the Testing Results for commercial or promotional purposes. Under no
circumstances shall the Company or any other party be authorized to refer to WHO, the
Company's participation in the Product Testing Programme, and/or the publication of the Testing
Results by WHO, in any statement or material of an advertising or promotional nature, press
release and/or similar public statement and/or other material aimed at promoting the Company,
any other party and/or the Product(s).
(7)
The Company shall provide the Information and sufficient quantities of the Product(s) to WHO, or
WHO’s designee(s), free of charge.
Upon receipt of a written request to that effect, the
Company shall furthermore pay any and all costs relating to the evaluation and testing process
hereunder to WHO, or WHO’s designee(s), in advance, in accordance with WHO’s instructions.
In the event that WHO, or its designee(s), do not receive the Information, and sufficient quantities
of the Product(s) by the required deadlines, WHO shall be under no obligation to arrange for the
performance of any evaluation or testing activities in relation to the Product(s). Any balance of
funds provided by the Company, and remaining unspent upon the conclusion of the testing and
evaluation process shall be returned to the Company, unless otherwise agreed by the Parties.
(8)
The Company hereby furthermore confirms that it has taken good note of, agrees with, accepts
and to the extent applicable, shall abide by, the provisions contained in the document, entitled
15
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
"Information for Manufacturers on WHO/TDR-FIND Malaria Rapid Diagnostic Test (RDT)
Product Testing Programme."
(9)
Any dispute relating to the interpretation or application of this Agreement shall, unless amicably
settled, be subject to conciliation. In the event of failure of the latter, the dispute shall be settled
by arbitration. The arbitration shall be conducted in accordance with the modalities to be agreed
upon by the Parties or, in the absence of agreement, with the rules of arbitration of the
International Chamber of Commerce. The Parties shall accept the arbitral award as final.
On behalf of WHO:
Signature:
On behalf of the Company:
Signature:
Name:
Name:
Title:
Title:
Date:
Date:
16
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
APPENDIX C
PRODUCTS TO BE INCLUDED FOR EVALUATION
Note: Please list up (number to be specified later by WHO-FIND) products, from the list of Expression of
Interest (EOI) already submitted to FIND
(Please note that details of products in this form should have previously been submitted to FIND, and that
no new product submitted in this form can be accepted for this round of testing).
Manufacturer Name
Product 1
Product 2
Product 3
(Catalogue No.)
(Catalogue No.)
(Catalogue No.)
Name:
Signature:
Designation / position:
Date:
Submit this form by email and hard copy to:
Julie Vercruysse
FIND
Foundation for Innovative New Diagnostics
16 Avenue de Budé
1202 Geneva
Switzerland
Tel: +41 (22) 710 05 97
Fax: +41 (22) 710 05 99
E-mail: [email protected] and [email protected]
Not later than: 15 Jan 2010
17
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
APPENDIX D
(1): Joint-submission and joint-listing of products
In cases where products with different names are produced on the same production line, a single product may be submitted for testing and identical products may be
jointly listed with the results. The manufacturer of the each separate product should submit a completed EOI. (Such co-submission will require a written application
from all the companies concerned and provision of evidence that the products are the same (in the form of a letter signed by the entity indicated as manufacturer
(assembler), and a letter signed by the entity or entities indicated as owner(s) of the other products listed as identical). (Please fill the Table on the next page).
In this context, 'manufacture' or 'assembly' indicates production of the test to a state in which it is contained in packaging designed to protect it from environmental
degradation (i.e. moisture-proof envelope), including conduct of the quality assurance process in place to ensure product quality. The name of the company which is
the operator of the site of manufacture or assembly will be indicated in the list of jointly listed products, together with the name of the company or companies owning
the identical products.
In the case of jointly listed products, if one product included in a list of jointly listed products is deemed by WHO-FIND to warrant de-listing due to poor performance
on lot testing, all jointly listed products will be de-listed and require re-application for product testing. Where products are submitted individually for testing, they will
be deemed to be independently manufactured and removal from the product list will involve only the product(s) named.4
4
In cases where a product is de-listed due to poor performance, WHO-FIND may require specific lot testing of other products believed to be the same as the de-listed product.
18
WHO/TDR-FIND Malaria Product Testing Programme – Round 3
APPENDIX D (cont'd.)
(2) Request for joint-submission and joint-listing of products as part of the WHO/TDR-FIND Malaria Diagnostics Product Testing Programme
The following products are manufactured under identical conditions at the same manufacturing site, and are considered re-labelled versions of the
same product. It is requested that they be listed as such in the publication of the performance results of product testing by WHO-FIND.
It is understood that in the event WHO-FIND requires a product to be re-tested due to concerns regarding performance, jointly listed products will be
considered as identical and will all be removed from the relevant WHO website lists.
Details of product submitted for testing and manufacturer of submitted product.
Name of manufacturer of
product submitted for
testing
Product
Name
Catalogue
Number
Plasmodium
species
1
targeted
Target
Antigen
(s)
2
Format
Dipstick: D
Cassette: Ca
Card: Cd
Contact
person and
designation
Address
Email
URL
Contact numbers
Details of product to be listed as identical (re-labelled)
Name of owner / user
of re-labelled product
name
Product
Name
Catalogue
Number
Contact person
and designation
Address
Email
URL
Contact numbers
Owner of the Product
Signature_______________________
Name _____________________________ Designation / position _________________________
Manufacturer of the Product
Signature_______________________
Name _____________________________ Designation / position _________________________
NOTE:
A separate signed letter must be provided by the manufacturer submitting product for testing, and the manufacturer/owner of the re-labelled product.
Manufacturer requesting for joint submission of a product should send the Expression of Interest (Appendix A) and Appendix D by 30 Nov 2009.
19
20, AVENUE APPIA – CH-1211 GENEVA 27 – SWITZERLAND – TEL CENTRAL +41 22 791 2111 – FAX CENTRAL +41 22 791 3111 – WWW.WHO.INT
Tel. direct: +41 22 791 2230
Fax direct: +41 22 791 4854
E-mail :
[email protected]
In reply please
refer to:
To all manufacturers
10 December 2009
Your reference:
Dear Manufacturer,
This letter is to acknowledge acceptance of your Expression of Interest in the WHO/TDR-FIND
Malaria RDT Product Testing Programme: Round 3
The letter contains important reminders and information regarding the following topics.
1.
2.
3.
4.
Future deadlines
Limits on number of products for submission
Special notes on ISO requirements
Availability of panels of cultured parasites for preliminary testing of products by
manufacturers: 'manufacturer's panel'
5. Summary of product testing procedure
6. Provisional timeline for product testing
7. Relationship of product testing to WHO RDT procurement of malaria RDTs
Please do not hesitate to contact me with any questions or concerns.
Yours sincerely,
Jane Cunningham
Technical Officer
WHO/TDR
Page 2/7
10 Dec. 09
Round 3 of WHO/TDR-FIND Malaria RDT Product Testing Programme
1. Next deadline
By 15 January 2010: the following items are required to qualify for participation in Round
3 of Product Testing Programme: These items are required even if they have been previously
submitted for Rounds 1 or 2 of Product Testing.
Documents to be submitted by E-mail followed by hard copy to:
Julie Vercruysse
FIND
16 Avenue de Budé
1202 Geneva
Switzerland
Tel: +41 (22) 710 05 97
Fax: +41 (22) 710 05 99
E-mail: [email protected]
With a copy to [email protected]
A. TWO original signed copies of the Confidentiality Agreement (APPENDIX B 1 )
(By hard copy and E-mail). One original will be signed by the Director of
WHO/TDR and returned to you by mail.
B. Current ISO 13485:2003 - see explicit conditions below (By hard copy and E-mail)
i.
In cases where an audit has been undertaken by an ISO 13485:2003 auditor,
but the certification is not yet available, WHO will accept a signed letter from
the auditor confirming that an audit has been undertaken and the certificate is
in process. The certificate must be submitted later by the final submission of
products the end of March 2010.
ii.
Some companies have submitted an ISO 13485:2003 certificate applying to a
site of product manufacturing and packaging under the name of another
company, without having a valid ISO 13485:2003 certificate naming the
company applying for product testing. ISO13485:2003 includes important
provision covering customer care and follow up of non-conformities with
expected performance. A product maybe accepted into Product Testing
Programme if:
ƒ A current ISO13485:2003 is submitted covering the site of manufacturing
and packaging of the product;
1
these documents (Appendix B, Annex 3) were sent with the original announcement of the
Round 3: EOI and are reattached to this correspondence - File name: Microsoft Word EOI-Annex 1_2_3 _rev 19 Oct 09-FINAL.pdf. Alternatively, they can be downloaded at:
http://www.wpro.who.int/sites/rdt/who_rdt_evaluation/call_for_testing_round3.htm
ƒ
ƒ
Page 3/7
10 Dec. 09
A signed letter from the holder/company of the ISO13485:2003 stating
that all manufacturing and packaging of the named products takes place
under the facility covered by the ISO certification.
The submitting company must obtain ISO 9001 by the end of November
2010 for the products to remain on the list of products tested under the
WHO Product Testing Programme and in subsequent publication of
results.
C. Provision of an acceptable heat stability protocol of internal quality assurance
(information on ANNEX 31). (By E-mail)
2. Limit on number of products to be submitted by each manufacturer
Due to the high volume of response to the EOI, we confirm that the number of products from
each company will be limited in Round 3. The anticipated limit will be at either 2 products or 3
products per company. However, a definitive decision will be announced via email in midJanuary 2010 once all applications have been reviewed and the final number of qualifying
companies/products is determined.
Therefore, you are NOT required to submit the final list of products and pamphlets (Appendix
C1) by 15th January as indicated in earlier correspondence.
3. Ordering panels of cultured parasites (P. falciparum) for preliminary
testing of products by manufacturers (optional)
A panel of samples derived from cultured P. falciparum, diluted and preserved at -80°C, are
available, free of charge. This panel will be a subset of the Phase One panel used for product
testing, and is intended to allow manufacturers to assess product quality prior to submitting
lots to the Product Testing programme. The panel is detailed in Table 1 and can be requested
by completing and returning Annex 1, of this document. Accessing this panel is optional, but
recommended.
This 'manufacturer's panel' has been prepared at US CDC and consists of aliquots of 5 cultured
P. falciparum parasite lines from geographically different endemic areas. Each of these
samples is provided at two parasite dilutions: 200, and 2,000 parasites per µl. The panel has
been tested against a number of commercially-available HRP2-detecting and pLDH-detecting
RDTs. The results indicate that all 2000 parasite/microL concentrations are expected to be
detected by good quality RDTs. The 200 parasite/microL samples can be detected by some
HRP2-detecting and pLDH-detecting RDTs but these samples are close to the detection limit of
currently-available tests. Should your products fail to detect samples at 2000 parasite/microL, it
is therefore likely that these products will not perform well in terms of antigen detection against
the complete product testing panel, and your company should seriously consider whether or
not you submit these products for further evaluation. As stated previously all results of RDTs
submitted to WHO for evaluation will be published.
Table 1.
Sample panel available to manufacturers for screening prior to product submission.
Page 4/7
10 Dec. 09
Sample type
Antigen type and concentrationa
n
Origin b
Testing
conditions
MANUFACTURERS PANEL
Pf HRP2
aldolase
Type
Conc.
Conc.
Conc.
ID: US03FBeninI/Benin I
A
10.18
4.23
0.71
ID: US02FSantaLucia/Santa Lucia
B
4.38
4.76
1
ID: US04FNigeriaXII/Nigeria XII *
B
5.93
4.69
0.63
ID: US03FFC27A3/FC27-A3
B
19.5
7.9
1.21
ID: US03FPH1/PH-1
C
5.9
2.54
0.96
P. falciparum (Pf) culture lines
5
pLDH
ID: Name of the Pf strains :
Benin,
West Africa
El Salvador,
Cen. Amer.
Nigeria,
West Africa
Papua
New Guinea
Dilutions
prepared: 200
and 2000 or
5000
parasites/μl)
Philippines
Note : samples characterized by microscopy, molecular species diagnosis, Pf HRP2 sequencing, and quantitative antigen ELISA.
a
Indication of the parasite antigen (Pf HRP2 types A / B / C and HRP2, pLDH and
aldolase antigen content (ng/mL) at 200 parasites/ml].content).
b
Geographical origin of parasite
strains
* Pf culture line used as the reference standard for RDT stability testing at the CDC and by the manufacturers participating in
the WHO/TDR-FIND RDT Evaluation Programme .
n = number of samples, p/µL = parasites per microlitre of blood.
Upon request, each manufacturer will receive a labeled panel consisting of frozen samples of
each of these culture lines, as 15 aliquots of 50 microL diluted to 200 parasites/microL, and 2000
parasites/microL (Total 15 x 2 x 5 = 450 aliquots). Panels are provided free of charge, but the
manufacturer is responsible for organizing and paying the costs of a courier, and organizing
permits and all passage through ports and customs once the sample has left the production site at
the United States Centre for Disease Control and Prevention (US CDC) in Atlanta, USA. Note
the samples should be shipped on dry ice (-78°C).
The courier company needs to liaise with the Ms. Sophie Jones via email ([email protected]) for
arranging the schedules of pick up of the panel. Loss or damage to the shipments is the
responsibility of consignee, and the shipper engaged by the consignee. Due to the limited
number of available samples, WHO can not guarantee that damaged or lost shipments will be
replaced.
Contact details for ordering panels:
Order by email:
Sophie Jones: [email protected]
Consigner
address for
courier
Sophie Jones
Centres for Disease Control and Prevention
Malaria Branch, Division for Parasitic Diseases
Bldg 109, Room 1118.6, MS F-36
4770 Buford Hwy NE
Chamblee, GA 30341 (USA)
ph: 770-488-3771 ; fax 770-488-4454
Email: [email protected]
cc: [email protected]
Note: All orders must be in the format detailed in Annex 1 (of this document).
Page 5/7
10 Dec. 09
4. Summary of product testing procedure (Figures 1a,b)
Figures 1 and 2 give a brief outline of product testing. A detailed description of the Product
Testing Programme and Standard operating procedures (Methods Manual for Product Testing of
Malaria Rapid Diagnostic Tests (Version 2) can be found at the following website:
http://www.wpro.who.int/sites/rdt/documents/list.htm
Figure 1:
a) Outline of the Product Testing Protocol
Evidence of quality
manufacturing
RDTs to specimen bank with
temperature monitor
Performance versus
panel
(Phase 1 and 2)
Heat Stability
Ease-of-Use
assessment
Longer-term
stability test by
manufacturer
Review of results by technical group
and subsequently circulated to manufacturers
Final publication
b) Phase 1 and Phase 2: Challenge Panel for malaria RDT Product Testing
Panel
samples
Panel
Phase 1
Phase 2
Pf culture panel
20 lines
Wild type Pf
≈100
Wildtype Pv
≈35
Negative panel
100
RDTs tested at each dilution
2 low,
1 high
2 low,
1 high
2 low,
1 high
2
Note: The final panel may vary slightly according to the availability of samples acceptable for
testing after characterization is completed.
Note: Each lot must detect 80% of the high density culture samples in Phase 1 before
progressing to Phase II evaluation panel.
Page 6/7
10 Dec. 09
5. Provisional timetable for product testing (times may change)
6. Relationship of product testing to WHO RDT procurement, and to
WHO prequalification of malaria RDTs
As with the 1st and 2nd round of Product testing, the results of the 3rd round of WHO/TDRFIND Malaria RDT Product Testing Programme will form the basis of procurement
recommendations of WHO and the WHO tendering programme. RDTs must be submitted to
Rounds 1, 2 or 3 of Product Testing Programme to be eligible for future WHO procurement.
Products accepted for the product testing programme will be listed on the WHO web site.
If products were submitted to Rounds 1 or 2 of Product Testing then this is sufficient for being
eligible to be listed for WHO bulk procurement. Products submitted to previous rounds may be
re-submitted to Round 3, but this is not necessary. If products are resubmitted, then from a
WHO procurement perspective, the test results from Round 3, will replace results from Round 1
and/or Round 2.
Page 7/7
10 Dec. 09
Annex 1:
Order Form - 'Manufacturers Panel' - culture-derived P. falciparum samples
Manufacturer Name
Manufacturer
(consignee) address
Courier company
contracted for
transport (including
full contact details).
Date requested for collection of
samples from CDC (dd/mm/yy):
Note: It is entirely the manufacturer's responsibility to contract the shipping agent (courier) and
undertake all necessary payments for transport, including supply of packaging materials and dry
ice.
The manufacturer should be experienced at transporting goods on dry ice (-78ºC). Note that the
consignment contains dead malaria parasites in human blood:
Category B Biological Substance - UN 3373
Human Blood Samples (Frozen) containing dead malaria parasites
Quantity: 150 vials containing 50 μL
For Laboratory Testing Only
Human material containing no animal material and not of tissue culture origin.
The shipping agent (courier) MUST contact CDC beforehand to arrange pick-up of samples. US
CDC has the discretion to vary the preferred pick-up date.
Contact details for ordering panels:
Order by email:
Sophie Jones: [email protected]
Consigner
address for
courier
Sophie Jones
Centres for Disease Control and Prevention
Malaria Branch, Division for Parasitic Diseases
Bldg 109, Room 1118.6, MS F-36
4770 Buford Hwy NE
Chamblee, GA 30341 (USA)
ph: 770-488-3771 ; fax 770-488-4454
Email: [email protected]
cc: [email protected]
Page 7/7
10 Dec. 09
Annex 1:
Order Form - 'Manufacturers Panel' - culture-derived P. falciparum samples
Manufacturer Name
Manufacturer
(consignee) address
Courier company
contracted for
transport (including
full contact details).
Date requested for collection of
samples from CDC (dd/mm/yy):
Note: It is entirely the manufacturer's responsibility to contract the shipping agent (courier) and
undertake all necessary payments for transport, including supply of packaging materials and dry
ice.
The manufacturer should be experienced at transporting goods on dry ice (-78ºC). Note that the
consignment contains dead malaria parasites in human blood:
Category B Biological Substance - UN 3373
Human Blood Samples (Frozen) containing dead malaria parasites
Quantity: 150 vials containing 50 μL
For Laboratory Testing Only
Human material containing no animal material and not of tissue culture origin.
The shipping agent (courier) MUST contact CDC beforehand to arrange pick-up of samples. US
CDC has the discretion to vary the preferred pick-up date.
Contact details for ordering panels:
Order by email:
Sophie Jones: [email protected]
Consigner
address for
courier
Sophie Jones
Centres for Disease Control and Prevention
Malaria Branch, Division for Parasitic Diseases
Bldg 109, Room 1118.6, MS F-36
4770 Buford Hwy NE
Chamblee, GA 30341 (USA)
ph: 770-488-3771 ; fax 770-488-4454
Email: [email protected]
cc: [email protected]
20, AVENUE APPIA – CH-1211 GENEVA 27 – SWITZERLAND – TEL CENTRAL +41 22 791 2111 – FAX CENTRAL +41 22 791 3111 – WWW.WHO.INT
Tel. direct:
Fax direct:
E-mail :
+41 22 791 2230
+41 22 791 4774
[email protected]
All manufacturers
In reply please
refer to:
Your reference:
31 January, 2010
Re: Round 3 of WHO/TDR-FIND Malaria RDT Product Testing
Dear Manufacturers,
The documents submitted have been reviewed and we are pleased to confirm acceptance of your
application to the WHO/TDR-FIND Malaria RDT Product Testing Programme - Round 3.
1. Limit on number of products to be submitted by each manufacturer
In order to keep to the programme's budget and timelines, we must limit the final number of
products per company to three. Therefore, if > 3 products were previously proposed for
evaluation, one product must be dropped.
All participants should now complete the form - Annex 1 (enclosed) containing the final list of
products and submit this information along with corresponding package inserts via email by
February 10, 2010. A hard copy must follow by mail as follows:
Julie Vercruysse
FIND
16 Avenue de Budé
1202 Geneva
Switzerland
Tel: +41 (22) 710 05 97
Fax: +41 (22) 710 05 99
E-mail: [email protected] and [email protected]
Page 2
2. Ordering panels of cultured parasites (P. falciparum) for preliminary
testing of products by manufacturers (OPTIONAL)
The manufacturer's panels will be available shortly (early March 2010) and as per earlier
instructions, to request a panel, the company must complete and following instructions
outlined in Annex 2 (enclosed).
3. Temperature monitors (OPTIONAL)
One temperature monitor per company will be available (for loan) in early March 2010, at no
cost, to use during the transportation of RDT lots to Centre for Disease Control and Prevention
(CDC), USA.
To request a temperature monitor, send an email to: [email protected]
with a copy to [email protected] .
Following the request you will receive a sample envelope for the temperature monitor with
information required to be completed by the manufacturer.
4. Obtaining the parasite dilutions for manufacturing site thermal stability
testing
All information is in the enclosed Annex 3 including a cover note, stability test protocol and
results template.
5. Shipment of RDTs to CDC, Atlanta
Detailed instructions for shipment of RDTs along with confirmation of the final product list, will
follow in a separate letter by mid-February. As in previous Rounds, products will be expected
to arrive at the CDC, Atlanta by 30 March.
Please don't hesitate to contact me should you have any questions or concerns.
Sincerely,
Dr. Jane Cunningham
Technical Officer
WHO/IER/TDR/DQR
World Health Organization
ANNEX 1
PRODUCTS TO BE INCLUDED FOR EVALUATION
Note: Please list maximum 3 products, from the list of Expression of Interest (EOI) already submitted to
FIND
(Please note that details of products in this form should have previously been submitted to FIND, and that
no new product submitted in this form can be accepted for this round of testing).
Manufacturer Name
Product 1
Product 2
Product 3
(Catalogue No.)
(Catalogue No.)
(Catalogue No.)
PACKAGE INSERT
INCLUDED
Name:
Signature:
Designation / position:
Date:
Submit this form AND PACKAGE INSERTS by email and hard copy to:
Julie Vercruysse
FIND
16 Avenue de Budé
1202 Geneva
Switzerland
Tel: +41 (22) 710 05 97
Fax: +41 (22) 710 05 99
E-mail: [email protected] and [email protected]
Not later than: 10 February 2010
ANNEX 2:
Order Form - 'Manufacturers Panel' - culture-derived P. falciparum samples
Manufacturer Name
Manufacturer
(consignee) address
Courier company
contracted for transport
(including full contact
details).
Date requested for collection of samples
from CDC (dd/mm/yy):
Note: It is entirely the manufacturer's responsibility to contract the shipping agent (courier)
and undertake all necessary payments for transport, including supply of packaging materials
and dry ice.
The manufacturer should be experienced at transporting goods on dry ice (-78ºC). Note that
the consignment contains dead malaria parasites in human blood:
Category B Biological Substance - UN 3373
Human Blood Samples (Frozen) containing dead malaria parasites
Quantity: 150 vials containing 50 μL
For Laboratory Testing Only
Human material containing no animal material and not of tissue culture origin.
The shipping agent (courier) MUST contact CDC beforehand to arrange pick-up of samples.
US CDC has the discretion to vary the preferred pick-up date.
Contact details for ordering panels:
Order by
email:
Sophie Jones: [email protected]
Consigner
address for
courier
Sophie Jones
Centres for Disease Control and
Prevention
Malaria Branch, Division for Parasitic
Diseases
Bldg 109, Room 1118.6, MS F-36
4770 Buford Hwy NE
Chamblee, GA 30341 (USA)
ph: 770-488-3771 ; fax 770-488-4454
Email: [email protected]
cc: [email protected]
ANNEX 3
Information pack on manufacturing site Stability Testing
1.
Covering note on Stability Testing requirement at manufacturing site
This note outlines requirements for the manufacturing site stability test of malaria RDT products
submitted for product testing. The testing process is detailed in the accompanying standard
operating procedures (SOP 2.2.d), and a standard report form is provided in electronic format
(by email) and hard copy. Please keep this note with SOP 2.2.d for future reference.
This stability test was specified in previous correspondence as a requirement for participation in
the product testing programme, which has now commenced. The test is intended to provide
real-time data on thermal stability at the maximum specified temperature recommended for each
product, for the duration of the recommended shelf-life, against standardized reference parasitepositive blood samples. The products of your company accepted into the programme are listed
in a letter document accompanying this document.
Production lots to be tested
The manufacturing site stability test should be performed using the same production lots as
those submitted for product testing to the US Centers for Disease Control and
Prevention (CDC), Atlanta, USA. If this is not possible, two other lots of the same product
should be used.
Duration of Testing
The initial test should be conducted by 30 May 2010, and both RDT lots should be under
incubation by this date. If this is not possible, WHO/TDR-FIND should be informed immediately
at the contact address below.
Testing should continue every 3 months until the expiry date of each lot of RDTs.
Recording and Reporting Results
The line intensity should be rated using the colour intensity rating scale provided (these will be
sent by courier later). The colour chart closest to the colour of the RDT test lines should be
selected, and used throughout. Note that the intensity rating is not intended to compare visibility
of lines between products, but to allow a reduction in intensity over time to be noted.
Results should be communicated to WHO/TDR-FIND every 3 months by email
attachment to [email protected] in the format provided and to [email protected]
Blood Reference Standard (Obtaining, and use of)
The reference standard is a culture-derived parasite P. falciparum parasite sample (Nigeria XII)
which forms part of the phase 1 testing panel of the product testing programme and is the
standard used for the thermal stability component of the product testing underway at CDC in
Atlanta, GA, USA.
CDC will provide sufficient aliquots of the parasite sample to test two lots of the products of each
manufacturer, using the blood volume specified in the manufacturer's product instructions. Blood
aliquots should be discarded after use, and not re-frozen.
The samples are provided as 50 L aliquots in dilutions of 200 parasites/L and 2000
parasites/L. If the 200 parasites/uL dilution does not produce a positive test result on initial
testing, this dilution may be excluded from the subsequent test at 3 monthly intervals, and the
dilution of 2000 parasites/ alone used.
The blood sample must be obtained from US CDC at the manufacturers expense. The samples
must be transported frozen (on dry ice, -78C) and stored at least at -20C after receipt.
Please note that the samples should be transported from CDC by engaging a courier
experienced in the transport of blood samples on dry ice, and in the relevant customs clearance
involved in such transport. The integrity of the samples during transport and on receipt, and the
process of clearing through customs and obtaining relevant national regulatory approvals, is the
responsibility of the manufacturer (consignee). WHO and CDC will assist with necessary
documentation on request.
The courier should be experienced at transporting goods on dry ice (-78ºC). Note that the
consignment contains dead malaria parasites in human blood:
Category B Biological Substance - UN 3373
Human Blood Samples (Frozen) containing dead malaria parasites
Quantity: XXX* vials containing 50 μL
For Laboratory Testing Only
Human material containing no animal material and not of tissue culture origin.
The shipping agent (courier) MUST contact CDC before hand to arrange pick-up of samples
and relevant documentation. CDC has the discretion to vary the preferred pick-up date.
Contact details for obtaining blood samples to be used in stability testing at the
manufacturing site:
Contact by
email:
Sophie Jones: [email protected]
Consigner
address for
courier
Sophie Jones
Centers for Disease Control and
Prevention (CDC)
cc: [email protected]
Malaria Branch, Division for Parasitic
Diseases
Bldg 109, Room 1118.6, MS F-36
4770 Buford Hwy NE
Chamblee, GA 30341
ph: 770-488-3771
fax 770-488-4454
Email: [email protected]
The parasite-negative blood sample necessary as a control in the testing process should be
provided by the manufacturer.
2.
Stability Test Protocol
Stability Assessment at Manufacturing Site
PURPOSE
This SOP describes the procedure for stability testing of a Rapid Diagnostic Test at the
manufacturing site, using standards provided by the WHO/TDR-FIND Malaria Rapid Diagnostic
Test Evaluation Programme.
SCOPE
This procedure applies to manufacturers participating in the malaria RDT product testing
programme of WHO/TDR and FIND with the US Centers for Disease Control and Prevention.
TESTING PROCEDURE (Refer to Figure 1)
1. General
a) Testing should occur at Day = 0, using 24 RDTs from each of 2 lots (total 48), then 12
RDTs from each of 2 lots (total 24) at each 3 monthly interval for the duration of the
manufacturer's recommended shelf life.
Test 8 RDTs against 200 parasites/μL
Test 8 RDTs against 2000 parasites/μL
Test 8 RDTs against negative sample
b) Store sufficient RDTs in the incubator incubator /environmental chamber to allow
testing of 40 RDTs (20 per lot) every 3 months for the remaining duration of the shelflife designated for that product by the manufacturer, and sufficient RDTs at 4° C (28°C) to allow testing of RDTs (12 per lot) every 3 months for the remaining duration of
the shelf-life.
c) Every three months, test 20 RDTs from each lot stored in the incubator and 12 from
each lot stored at 4°C:
 From 4°C storage:
Test 4 RDTs against 200 parasites/L
Test 4 RDTs against 2000 parasites/L
Test 4 RDTs against negative sample
 From incubator:
Test 8 RDTs against 200 parasites/L
Test 8 RDTs against 2000 parasites/L
Test 4 RDTs against negative sample
d) Incubated RDTs should be stored at the maximum storage temperature
recommended by the manufacturer.
e) Allow a minimum 3 days to calibrate incubators prior to conducting baseline testing.
f) Incubator temperatures and refrigerator temperatures should be recorded daily on a
chart attached to the incubator or closely accessible
g) Mark days when testing is due at 3 month intervals for remainder of shelf life.
h) RDTs should be stacked in incubators in their normal packaging (boxes / kits),
allowing air circulation against at least 2 sides of box, and not in direct contact with
walls or floor of incubator.
i) All documentation should be readily accessible if manufacturer site inspections occur.
Table A: Number of RDTs required per lot for STABILITY TESTING.
Test
RDTs required per RDT required per Total RDTs
lot
at
storage lot at 4o C
(both lots)
temperature
Baseline
24
48
Each 3 months
20
12
64
Expiry date
20
12
64
Example for 2 year shelf-life, 3 month old lot when testing commences:
Baseline
24
48
6x3 months
120
72
384
Expiry date
20
12
64
Spare
20
12
64
Total per lot
184
96
560
2. Preparation of product and sample
a) Blood samples to be used as the positive standard for testing are supplied from WHO /
CDC (manufacturer must arrange and fund courier), in aliquots of 200
parasites/microL and 2000 parasites/microL, and should be stored at ≤-20°C.
b) Test in air-conditioned (low humidity) environment, at ≤25°C with good lighting.
c) Thaw sufficient aliquots of blood samples designated for RDT stability testing for 30
minutes at room temperature (<30°C) (Each aliquot is approximately 50 microL, so for
RDTs requiring 5 uL blood, it is recommended to thaw 3 samples)
d) Store samples aliquots at 4°C after thawing
e) All blood samples must be used within 8 hours of thaw. Do not re-freeze.
f) Withdraw the correct number of RDTs of each lot from storage (incubator and 4°C –
Figure 1) and allow to reach room temperature before opening envelope.
g) Test the correct number of RDTs from each lot (diagram below), against aliquots of
200 parasites/microL and 2000 parasites/microL and parasite-negative samples. (If all
RDTs have failed at 200 parasite/microL at a previous testing interval, this aliquot may
be removed from the testing procedure at future testing intervals.
Follow
manufacturer's RDT preparation procedure for each product, using pipette or
manufacturer's blood transfer device to obtain correct blood volume.
h) If both lots of a product fail to detect the 200 parasites/microL sample at the initial test,
the 200 parasite/L sample may be excluded from future testing and subsequent tests
at 3 month intervals conducted using the 2000 parasites/microL sample only.
3. Reading and reporting results
a) Read result within the time period specified by manufacturer, rating line intensity 0-4
against colour intensity chart provided (Use colour closest to colour of positive line).
(Colour intensity charts sent to you by courier with other hard copies)
b) Record on the record sheet provided in hard copy and electronic copy.
c) Submit results to WHO/TDR-FIND at the specified intervals.
d) Submission of results may cease once all RDTs have failed at any testing interval.
Stability Evaluation at Manufacturing Site
Select sufficient RDTs of each of 2 lots to test:
20 RDTs initially,
32 RDTs at 3 month intervals throughout shelf-life, and at end of shelf life.
It is advised to add at least 64 additional RDTs to allow for errors in process.
Time = 0
Baseline testing
24 RDTs per lot
Test 8 RDTs against 200 parasites/μL
Test 8 RDTs against 2000 parasites/μL
Test 8 RDTs against negative sample
Store at 4°C
Sufficient for 12 RDTs per
3 months (each lot)
(consider 12 spare)
Store at maximum storage
temperature specified in
product instructions
Sufficient for 20 RDTs per 3
months (each lot) (consider
20 spare)
(Consider 40 spare)
Record results (Form
Time = 3, 6, 9, 12,
15, 18 … mths to
end of shelf life (or
until all RDTs fail)
Test every 3 months, each lot
Test 4 RDTs against 200 parasites/L
Test 4 RDTs against 2000 parasites/L
Test 4 RDTs against negative sample
Test every 3 months, each lot
Test 8 RDTs against 200 parasites/L
Test 8 RDTs against 2000 parasites/L
Test 4 RDTs against negative sample
Record results (Form
36a)
Time = Lot expiry
date
Test each lot
Test 4 RDTs against 200 parasites/L
Test 4 RDTs against 2000 parasites/L
Test 4 against negative sample
Test each lot
Test 8 RDTs against 200 parasites/L
Test 8 RDTs against 2000 parasites/L
Test 4 RDTs against negative sample
Record results (Form 36a)
Report results (cumulative)
Figure 1: Stability Test Flowchart
3.
Stability Test Result template
Form 036a: STABILITY TEST: MANUFACTURER’S RESULT SHEET
Manufacturer:
Product:
Lot:
TIME OF READING (INTERVAL IN MONTHS) ('0', or '3', '6' etc):
Technician (Name ……………………………………)
Colour chart used:
Parasite
density:
Negative, 200,
2000 para/uL
Result: Rate colour intensity 0-4 using colour chart provided)
Time of
preparation
Time of
reading
Control
Line 1
Line 2
Line 3
Comment
Interpretation
(species)
Negative
Negative
Negative
Negative
Negative
Negative
Negative
Negative
200 para/L
200 para/L
200 para/L
200 para/L
200 para/L
200 para/L
200 para/L
200 para/L
2000 para/L
2000 para/L
2000 para/L
2000 para/L
2000 para/L
2000 para/L
2000 para/L
2000 para/L
Result should be recorded according to intensity of line, referenced against 'colour rating chart'
provided. 'Control': Control line. 'Line 1 -3': Test result lines, as appropriate for the product.
Signed: …………………………………
WHO/TDR-FIND Malaria RDT Product Testing Programme - Rd 3 - Letter 3 - Annexes
20, AVENUE APPIA – CH-1211 GENEVA 27 – SWITZERLAND – TEL CENTRAL +41 22 791 2111 – FAX CENTRAL +41 22 791 3111 – WWW.WHO.INT
Tel. direct:
Fax direct:
E-mail :
+41 22 791 2230
+41 22 791 4774
[email protected]
In reply please
refer to:
Your reference:
22 February 2010
Dear Manufacturer,
Re: Round 3 of WHO/TDR-FIND Malaria RDT Product Testing
1. Confirmation of final list of products
In follow up to recent email correspondence, we kindly request that you confirm via email (to
[email protected]) the following products for inclusion in WHO/TDR-FIND
Malaria RDT Product Testing Programme - Round 3 at US CDC:



ABC Catalog# 123
ABC Catalog# 123
ABC Catalog# 123
2. Obtaining panels of cultured parasites (P. falciparum) for preliminary
testing of products by manufacturers (OPTIONAL)
As per the last correspondence (1 Feb, 2010), the manufacturer's panels are available. To
request a panel, the company must complete and follow instructions outlined in Annex 1
(enclosed).
3. Temperature monitors (OPTIONAL)
Temperature monitors will be shipped in specially formatted envelopes the week of 22
February 2010, to requesting parties.
Page 2
Instructions on how to fill in the required information on the envelopes is included in Annex 2
(enclosed).
To request a temperature monitor, send an email to: [email protected]
with a copy to [email protected] .
4. AMENDMENT TO PRODUCT TESTING REQUIREMENTS
Manufacturing site thermal stability testing
The WHO Malaria Specimen Bank Committee has recommended that for Round 3,
performance of on-site thermostability evaluation of the submitted lots by the manufacturer
using a reference sample and SOP provided by the programme should be OPTIONAL.
Submission of these results is no longer required. This was previously a requirement for
participation in WHO/TDR-FIND Malaria Product Testing.
However, should a manufacturer wish to continue to follow these procedures using the
reference sample from US CDC, this will be made available. Further information is enclosed
in Annex 3 including a cover note, stability test protocol and results template.
5. Shipment of RDTs to CDC, Atlanta
Detailed instructions for shipment of RDTs are included in Annex 4. Products must arrive
at the CDC, Atlanta by 30 March, 2010. Confirmation of receipt will be sent via email.
6. Protocol modifications for Round 3
In Round 3, heat stability testing at the CDC will NOT be performed on high density (2000
parasites/μl) P. falciparum culture samples.
As noted above (4.), manufacturer site stability testing is no longer a requirement for
participation in WHO/TDR-FIND Malaria RDT Product Testing.
Please don't hesitate to contact me should you have any questions or concerns.
Sincerely,
Dr. Jane Cunningham
Technical Officer
WHO/IER/TDR/DQR
World Health Organization
Annex 1(1): Availability of panels of cultured P. falciparum parasites
for preliminary testing of products by manufacturers (optional)
A panel of samples derived from cultured P. falciparum, diluted and preserved at -80°C,
are now available. This panel will be a subset of the Phase One panel used for product
testing, and is intended to allow manufacturers to assess product quality prior to
submitting lots to the Product Testing programme. The panel is detailed in Table
1. Accessing this panel is optional, but recommended.
This 'manufacturer's panel' has been prepared at US CDC and consists of aliquots of
5 cultured P. falciparum parasite lines from geographically different endemic areas. Each
of these samples is provided at different parasite dilutions: 200, and 2,000 parasites
per µl. The panel has been tested against a number of commercially-available HRP2detecting and pLDH-detecting RDTs. The results indicate that all 5000 parasite/microL
concentrations are expected to be detected by good quality RDTs. The 200
parasite/microL samples can be detected by some HRP2-detecting pLDH and HRP2
RDTs but these samples are close to the limit of currently-available tests. Should
your products fail to detect samples at 5000 parasite/microL, it is therefore likely that
these products will not perform well in terms of antigen detection against the complete
product testing panel, and your company should seriously consider whether or not you
submit these products for further evaluation. As stated previously all results of RDTs
submitted to WHO for evaluation will be published.
Table 1. Sample panel available to manufacturers for screening prior to product submission.
Sample
Benin I
Santa Lucia
Nigeria XII
FC27/A3
PH1
HRP2 sequence type1
A
B (high)
B (medium)
B (low)
C
Derivation of sample
Benin, Africa
El Salvador, Central America
Nigeria, Africa
Papua New Guinea, Australasia
Philippines, Southeast Asia
Each manufacturer may receive a labelled panel consisting of frozen samples of each of
these culture lines, as 15 aliquots of 50 microL diluted to 200 parasites/microL, and 5000
parasites/microL (Total 15 x 2 x 5 = 150 aliquots). Panels are provided free of charge,
but the manufacturer is responsible for organizing and paying the costs of courier,
and organizing all passage through ports and customs once the sample has left the
production site at the United States Centre for Disease Control and Prevention (US CDC) in
Atlanta, USA. Note the samples should be shipped on Dry Ice (-78°C). The courier company
needs to liaise with the Sophie Jones of Centre for Disease Control and Prevention (CDC),
Atlanta, USA ([email protected]) for arranging the schedules of pick up of the parasite dilution
samples. Loss or spoilage of shipments is the responsibility of consignee, and the shipper
engaged by the consignee. Due to the limited number of available samples, WHO can not
guarantee that spoilt or lost shipments will be replaced.
WHO/TDR-FIND Malaria RDT Product Testing - Round 3 - Letter 3b attachments
Contact details for ordering panels:
Order by
email:
Sophie Jones: [email protected]
Consigner
address
for courier
Sophie Jones
Centres for Disease Control and
Prevention
Malaria Branch, Division for Parasitic
Diseases
Bldg 109, Room 1118.6, MS F-36
4770 Buford Hwy NE
Chamblee, GA 30341
ph: 001 770-488-7458
fax 001 770-488-4454
Email: [email protected]
cc: [email protected]
Note: All orders must be in the format detailed in Annex 1 (2) of this document.
WHO/TDR-FIND Malaria RDT Product Testing - Round 3 - Letter 3b attachments
Annex 1 (2): Order Form - 'Manufacturers Panel' - culture-derived P.
falciparum samples
Manufacturer Name
Manufacturer
(consignee) address
Courier company
contracted for transport
(including full contact
details).
Date requested for collection of samples
from CDC (dd/mm/yy):
Note: It is entirely the manufacturer's responsibility to contract the shipping agent (courier) and undertake
all necessary payments for transport, including supply of packaging materials and dry ice.
The manufacturer should be experienced at transporting goods on dry ice (-78ºC). Note that the
consignment contains dead malaria parasites in human blood:
Category B Biological Substance - UN 3373
Human Blood Samples (Frozen) containing dead malaria parasites
Quantity: 150 vials containing 50 μL
For Laboratory Testing Only
Human material containing no animal material and not of tissue culture origin.
The shipping agent (courier) MUST contact CDC beforehand to arrange pick-up of samples. US CDC has
the discretion to vary the preferred pick-up date.
Contact details for ordering panels:
Order by
email:
Consigner
address for
courier
Sophie Jones: [email protected]
cc: [email protected]
Sophie Jones
Centres for Disease Control and Prevention
Malaria Branch, Division for Parasitic
Diseases
Bldg 109, Room 1118.6, MS F-36
4770 Buford Hwy NE
Chamblee, GA 30341
ph: 001 770-488-7458
fax: 001 770-488-4454
Email: [email protected]
WHO/TDR-FIND Malaria RDT Product Testing - Round 3 - Letter 3b attachments
Annex 2: Temperature monitor envelope and information needed
Note:
1. The temperature monitors will be available to manufacturers cost-free upon request. (Optional)
2. The above picture is a sample envelope which the temperature monitor is sent to you, when you
request it from [email protected]
3. Please fill in the information on the back of the envelope sent to you (which contains the
temperature monitor) and place it with your RDTs transported to Centre for Disease Control and
Prevention (CDC), Atlanta, USA for Product testing.
4. The yellow highlighted sections show information that manufacturers need to fill in before sending
the temperature monitor with RDT products to CDC, USA. Please read the following instructions:

Please leave the monitor inside this envelope (there is no need to open the envelope).

ON THE BACK OF THE ENVELOPPE: Fill in the date & time when the envelope was
placed in the box of RDT's;

ON THE BACK OF THE ENVELOPPE: Duly fill in the table in order to keep track of the
temperature monitor’s location (Arrival + Departure). Please follow FIND’s example in
blue.

Please place this envelope safely inside the box together with the RDT's before the lot is
sent/shipped to the Centers for Disease Control and Prevention (CDC) in Atlanta, USA.
WHO/TDR-FIND Malaria RDT Product Testing - Round 3 - Letter 3b attachments
Annex 3: Information pack on manufacturing site Stability Testing
NOW OPTIONAL for ROUND 3 PARTICIPANTS
1.
Covering note on Stability Testing requirement at manufacturing site This note outlines requirements for the manufacturing site stability test of malaria RDT products
submitted for product testing. The testing process is detailed in the accompanying standard
operating procedures (SOP 2.2.d), and a standard report form is provided in electronic format (by
email) and hard copy. Please keep this note with SOP 2.2.d for future reference.
This stability test was specified in previous correspondence as a requirement for participation in
the product testing programme, which has now commenced. The test is intended to provide realtime data on thermal stability at the maximum specified temperature recommended for each
product, for the duration of the recommended shelf-life, against standardized reference parasitepositive blood samples. The products of your company accepted into the programme are listed in
a letter document accompanying this document.
Production lots to be tested
The manufacturing site stability test should be performed using the same production lots as
those submitted for product testing to the US Centers for Disease Control and Prevention
(CDC), Atlanta, USA. If this is not possible, two other lots of the same product should be used.
Duration of Testing
The initial test should be conducted by 30 May 2010, and both RDT lots should be under
incubation by this date. If this is not possible, WHO/TDR-FIND should be informed immediately
at the contact address below.
Testing should continue every 3 months until the expiry date of each lot of RDTs.
Recording and Reporting Results
The line intensity should be rated using the colour intensity rating scale provided (these will be
sent by courier later). The colour chart closest to the colour of the RDT test lines should be
selected, and used throughout. Note that the intensity rating is not intended to compare visibility
of lines between products, but to allow a reduction in intensity over time to be noted.
Results should be communicated to WHO/TDR-FIND every 3 months by email attachment
to [email protected] in the format provided and to [email protected]
WHO/TDR-FIND Malaria RDT Product Testing - Round 3 - Letter 3b attachments
Blood Reference Standard (Obtaining, and use of)
The reference standard is a culture-derived parasite P. falciparum parasite sample (Nigeria XII)
which forms part of the phase 1 testing panel of the product testing programme and is the
standard used for the thermal stability component of the product testing underway at CDC in
Atlanta, GA, USA.
CDC will provide sufficient aliquots of the parasite sample to test two lots of the products of each
manufacturer, using the blood volume specified in the manufacturer's product instructions. Blood
aliquots should be discarded after use, and not re-frozen.
The samples are provided as 50 L aliquots in dilutions of 200 parasites/L and 2000
parasites/L. If the 200 parasites/uL dilution does not produce a positive test result on initial
testing, this dilution may be excluded from the subsequent test at 3 monthly intervals, and the
dilution of 2000 parasites/ alone used.
The blood sample must be obtained from US CDC at the manufacturers expense. The samples
must be transported frozen (on dry ice, -78C) and stored at least at -20C after receipt.
Please note that the samples should be transported from CDC by engaging a courier experienced
in the transport of blood samples on dry ice, and in the relevant customs clearance involved in
such transport. The integrity of the samples during transport and on receipt, and the process of
clearing through customs and obtaining relevant national regulatory approvals, is the
responsibility of the manufacturer (consignee). WHO and CDC will assist with necessary
documentation on request.
The courier should be experienced at transporting goods on dry ice (-78ºC). Note that the
consignment contains dead malaria parasites in human blood:
Category B Biological Substance - UN 3373
Human Blood Samples (Frozen) containing dead malaria parasites
Quantity: XXX* vials containing 50 μL
For Laboratory Testing Only
Human material containing no animal material and not of tissue culture origin.
The shipping agent (courier) MUST contact CDC before hand to arrange pick-up of samples and
relevant documentation. CDC has the discretion to vary the preferred pick-up date.
Contact details for obtaining blood samples to be used in stability testing at the
manufacturing site:
Contact by
email:
Consigner
address for
courier
Sophie Jones: [email protected]
cc: [email protected]
Sophie Jones
Centers for Disease Control and
Prevention (CDC)
Malaria Branch, Division for Parasitic
Diseases
Bldg 109, Room 1118.6, MS F-36
4770 Buford Hwy NE
WHO/TDR-FIND Malaria RDT Product Testing - Round 3 - Letter 3b attachments
Chamblee, GA 30341
ph: 770-488-3771
fax 770-488-4454
Email: [email protected]
The parasite-negative blood sample necessary as a control in the testing process should be
provided by the manufacturer.
WHO/TDR-FIND Malaria RDT Product Testing - Round 3 - Letter 3b attachments
2. Stability Test Protocol
Stability Assessment at Manufacturing Site
PURPOSE
This SOP describes the procedure for stability testing of a Rapid Diagnostic Test at the
manufacturing site, using standards provided by the WHO/TDR-FIND Malaria Rapid
Diagnostic Test Evaluation Programme.
SCOPE
This procedure applies to manufacturers participating in the malaria RDT product testing
programme of WHO/TDR and FIND with the US Centers for Disease Control and Prevention.
TESTING PROCEDURE (Refer to Figure 1)
1. General
a) Testing should occur at Day = 0, using 24 RDTs from each of 2 lots (total 48), then 12
RDTs from each of 2 lots (total 24) at each 3 monthly interval for the duration of the
manufacturer's recommended shelf life.
Test 8 RDTs against 200 parasites/μL
Test 8 RDTs against 2000 parasites/μL
Test 8 RDTs against negative sample
b) Store sufficient RDTs in the incubator incubator /environmental chamber to allow
testing of 40 RDTs (20 per lot) every 3 months for the remaining duration of the shelflife designated for that product by the manufacturer, and sufficient RDTs at 4° C (28°C) to allow testing of RDTs (12 per lot) every 3 months for the remaining duration of
the shelf-life.
c) Every three months, test 20 RDTs from each lot stored in the incubator and 12 from
each lot stored at 4°C:
 From 4°C storage:
Test 4 RDTs against 200 parasites/L
Test 4 RDTs against 2000 parasites/L
Test 4 RDTs against negative sample
 From incubator:
Test 8 RDTs against 200 parasites/L
Test 8 RDTs against 2000 parasites/L
Test 4 RDTs against negative sample
d) Incubated RDTs should be stored at the maximum storage temperature recommended
by the manufacturer.
e) Allow a minimum 3 days to calibrate incubators prior to conducting baseline testing.
WHO/TDR-FIND Malaria RDT Product Testing - Round 3 - Letter 3b attachments
f) Incubator temperatures and refrigerator temperatures should be recorded daily on a
chart attached to the incubator or closely accessible
g) Mark days when testing is due at 3 month intervals for remainder of shelf life.
h) RDTs should be stacked in incubators in their normal packaging (boxes / kits),
allowing air circulation against at least 2 sides of box, and not in direct contact with
walls or floor of incubator.
i) All documentation should be readily accessible if manufacturer site inspections occur.
Table A: Number of RDTs required per lot for STABILITY TESTING.
RDTs required per RDT required per Total RDTs
lot
at
storage lot at 4o C
(both lots)
temperature
Baseline
24
48
Each 3 months
20
12
64
Expiry date
20
12
64
Example for 2 year shelf-life, 3 month old lot when testing commences:
Baseline
24
48
6x3 months
120
72
384
Expiry date
20
12
64
Spare
20
12
64
Total per lot
184
96
560
Test
2. Preparation of product and sample
a) Blood samples to be used as the positive standard for testing are supplied from WHO /
CDC (manufacturer must arrange and fund courier), in aliquots of 200 parasites/microL
and 2000 parasites/microL, and should be stored at ≤-20°C.
b) Test in air-conditioned (low humidity) environment, at ≤25°C with good lighting.
c) Thaw sufficient aliquots of blood samples designated for RDT stability testing for 30
minutes at room temperature (<30°C) (Each aliquot is approximately 50 microL, so for
RDTs requiring 5 uL blood, it is recommended to thaw 3 samples)
d) Store samples aliquots at 4°C after thawing
e) All blood samples must be used within 8 hours of thaw. Do not re-freeze.
f) Withdraw the correct number of RDTs of each lot from storage (incubator and 4°C –
Figure 1) and allow to reach room temperature before opening envelope.
g) Test the correct number of RDTs from each lot (diagram below), against aliquots of
200 parasites/microL and 2000 parasites/microL and parasite-negative samples. (If all
RDTs have failed at 200 parasite/microL at a previous testing interval, this aliquot may
be removed from the testing procedure at future testing intervals. Follow
manufacturer's RDT preparation procedure for each product, using pipette or
manufacturer's blood transfer device to obtain correct blood volume.
h) If both lots of a product fail to detect the 200 parasites/microL sample at the initial test,
the 200 parasite/L sample may be excluded from future testing and subsequent tests at
3 month intervals conducted using the 2000 parasites/microL sample only.
WHO/TDR-FIND Malaria RDT Product Testing - Round 3 - Letter 3b attachments
3. Reading and reporting results
a) Read result within the time period specified by manufacturer, rating line intensity 0-4
against colour intensity chart provided (Use colour closest to colour of positive line).
(Colour intensity charts sent to you by courier with other hard copies)
b) Record on the record sheet provided in hard copy and electronic copy.
c) Submit results to WHO/TDR-FIND at the specified intervals.
d) Submission of results may cease once all RDTs have failed at any testing interval.
WHO/TDR-FIND Malaria RDT Product Testing - Round 3 - Letter 3b attachments
Stability Evaluation at Manufacturing Site
Select sufficient RDTs of each of 2 lots to test:
20 RDTs initially,
32 RDTs at 3 month intervals throughout shelf-life, and at end of shelf life.
It is advised to add at least 64 additional RDTs to allow for errors in process.
Time = 0
Baseline testing
24 RDTs per lot
Test 8 RDTs against 200 parasites/μL
Test 8 RDTs against 2000 parasites/μL
Test 8 RDTs against negative sample
Store at 4°C
Sufficient for 12 RDTs per
3 months (each lot)
(consider 12 spare)
Store at maximum storage
temperature specified in
product instructions
Sufficient for 20 RDTs per 3
months (each lot) (consider
20 spare)
(Consider 40 spare)
Record results (Form
Time = 3, 6, 9, 12,
15, 18 … mths to
end of shelf life (or
until all RDTs fail)
Test every 3 months, each lot
Test 4 RDTs against 200 parasites/L
Test 4 RDTs against 2000 parasites/L
Test 4 RDTs against negative sample
Test every 3 months, each lot
Test 8 RDTs against 200 parasites/L
Test 8 RDTs against 2000 parasites/L
Test 4 RDTs against negative sample
Record results (Form
36a)
Time = Lot expiry
date
Test each lot
Test 4 RDTs against 200 parasites/L
Test 4 RDTs against 2000 parasites/L
Test 4 against negative sample
Test each lot
Test 8 RDTs against 200 parasites/L
Test 8 RDTs against 2000 parasites/L
Test 4 RDTs against negative sample
Record results (Form 36a)
Report results (cumulative)
Figure 1: Stability Test Flowchart
WHO/TDR-FIND Malaria RDT Product Testing - Round 3 - Letter 3b attachments
3. Stability Test Result template Form 036a: STABILITY TEST: MANUFACTURER’S RESULT SHEET
Manufacturer:
Product:
Lot:
TIME OF READING (INTERVAL IN MONTHS) ('0', or '3', '6' etc):
Technician (Name ……………………………………)
Colour chart used:
Parasite
density:
Negative, 200,
2000 para/uL
Result: Rate colour intensity 0-4 using colour chart provided)
Time of
preparation
Time of
reading
Control
Line 1
Line 2
Line 3
Comment
Interpretation
(species)
Negative
Negative
Negative
Negative
Negative
Negative
Negative
Negative
200 para/L
200 para/L
200 para/L
200 para/L
200 para/L
200 para/L
200 para/L
200 para/L
2000 para/L
2000 para/L
2000 para/L
2000 para/L
2000 para/L
2000 para/L
2000 para/L
2000 para/L
Result should be recorded according to intensity of line, referenced against 'colour rating chart' provided.
'Control': Control line. 'Line 1 -3': Test result lines, as appropriate for the product.
Signed: …………………………………
WHO/TDR-FIND Malaria RDT Product Testing - Round 3 - Letter 3b attachments
Annex 4:
SOPs for transportation of products to US CDC
1.
Products can be accompanied by a temperature monitor provided by WHO cost free upon
request to [email protected] with a copy to [email protected].
2.
The temperature monitor cover envelope must be duly filled in by the manufacturer
according to the instructions in Annex 2 of this letter.
3.
Temperature monitor should be placed with the cover envelope inside with the RDT
products during transportation.
4.
Appropriate number of products, 1100 products from each of two lots for each
product listed on the final products list must be submitted to Centre for Disease Control
and Prevention (CDC), Atlanta, USA by 30th March 2010.
Shipping address:
Sophie Jones & John Barnwell
Center for Disease Control and Prevention
Chief, Laboratory Research and Development Unit
Malaria Branch, Division of Parasitic Diseases
Bldg. 109, Room 1121 MS F-36
4770 Buford Highway NE, 30341, Georgia, USA
Email: [email protected]
[email protected]
Phone: 770-488-7458
5.
It is advisable to use the phrase '' These Malaria RDT kits are for in vitro diagnostic use in
humans and not for use in animals. These kits are for evaluation purposes by US CDC
under the WHO/TDR-FIND Malaria RDT Product Testing Programme Round 3. These will
not be used for any in vitro diagnostic purposes within the territory of United States of
America'' on the RDT courier boxes being transported to US CDC to minimize the custom
issues.
6.
In cases of unexpected custom issues or other delays, WHO([email protected]) and
FIND ([email protected]) should be informed of proof of products
leaving manufacturing site before the deadline, other related correspondence, courier
tracking numbers etc and these special situations need to be discussed with WHO Malaria
Specimen Bank Steering Committee for eligibility for participation in the Programme and
conveyed to manufacturers accordingly.
WHO/TDR-FIND Malaria RDT Product Testing - Round 3 - Letter 3b attachments
Manufacturers and products accepted into Round 3 of WHO Malaria RDT Product Testing Programme
Target antigen(s)
Manufacturer
Product Name
Catalogue No
ABON Biopharm (Hangzhou) Co. Ltd
ABON Malaria Pan/P.f. Rapid Test Device (Whole Blood)
IMA-B402
HRP2
pan aldolase
Access Bio, Inc.
CareStart ™Malaria pLDH 3 Line Test
CareStart™ Malaria/Pregnancy Combo (pLDH/HRP2/HCG)
G0121
G0221
pan pLDH
HRP2
pf pLDH
pan pLDH
CareStart™ Malaria Screen
G0231
Pf HRP2/Pf pLDH
pan pLDH
Surestep™ Malaria Pf/Pan Rapid Test Device (Whole Blood)
IMA-T402
HRP2
pan aldolase
Malaria pf (pLDH) / PAN-pLDH Test Device
Malaria pf (HRP II) / pv (pLDH) Antigen Detection Test Device
Malaria pf (HRP II) / (PAN-LDH) Antigen Detection Test Device
Nano Sign Malaria Pf Ag
NanoSign Malaria Pf/Pan Ag
NanoSign Malaria Pf/Pv Ag
BIONOTE MALARIA P.f&P.v Ag Rapid Test Kit
BIONOTE MALARIA P.f&Pan Ag Rapid Test Kit
BIONOTE MALARIA P.f Ag Rapid Test Kit
IMMUNOQUICK CONTACT falciparum
IMMUNOQUICK CONTACT MALARIA +4
One Step Malaria P.F Test (cassette)
Core™ Malaria Pf
Core™ Malaria Pv/Pf
Core™ Malaria Pan/Pv/Pf
OnSite Pf Ag Rapid Test
OnSite Pf/Pan Malaria Ag Rapid Test
OnSite Malaria Pf/Pv Ag Rapid Test
OptiMAL-IT
MFV-124
MFV-124V
MFV-124R
RMAF10
RMAP10
RMAD10
RG19-12
RG19-08
RG19-11
0519K25
0525K25
522352
MAL-190020
Mal-190022
Mal-190026
R0114C
R0113C
R0112C
710024
ACON Biotech (Hangzhou) Co. Ltd
AZOG,Inc
Bioland, Ltd
BioNote,Inc.
Biosynex
Blue Cross Bio-Medical (Beijing) Co., Ltd.
Core Diagnostics
CTK Biotech, Inc.
DiaMed - A Division of Bio-Rad
Dima • Gesellschaft für Diagnostika mbH
Malaria Pan test
MAL-W23N-001
pan pLDH
pv pLDH
pan pLDH
HRP2
HRP2
pan pLDH
HRP2
HRP2
HRP2
HRP2
HRP2
HRP2
HRP2
HRP2
HRP2
HRP2
HRP2
HRP2
Pan pLDH
HRP2
HCG
pf pLDH
HRP2
HRP2
pan pLDH
pf pLDH
pv pLDH
pan pLDH
pan pLDH
pv pLDH
pan pLDH
pan pLDH
Pv pLDH
Pf pLDH
pan aldolase
Pv pLDH
R & R Marketing / ICT Diagnostics
InTec Products, Inc.
J. Mitra & Co. Pvt. Ltd.
Orchid Biomedical Systems
Orgenics Ltd. (Inverness Medical Innovations)
Standard Diagnostics Inc.
Span Diagnotics Ltd.
SSA Diagnostics & Biotech Systems
Vision Biotech (Pty) Ltd
Guangzhou Wondfo Biotech Co. Ltd.
Zephyr Biomedical Systems
ICT Diagnostics Malaria Combo
ML02
HRP2
pan aldolase
ICT Diagnostics Malaria Dual
ICT Diagnostics Malaria P.f
Advanced Quality™ One Step Malaria P.f/P.v Tri-line Test
Advanced Quality™ One Step Malaria P.f Test
Advantage Malaria Card
Paracheck® Pf Device - Rapid test for P. falciparum Malaria
Paracheck® Pf Dipstick - Rapid test for P. falciparum Malaria
ML03
ML01
ITP11003 TC40
ITP11002 TC40
IR211025
30301025
30302025
HRP2
HRP2
HRP2
HRP2
HRP2
HRP2
HRP2
pan pLDH
Clearview® Malaria pLDH
70884025
pan pLDH
SD BIOLINE Malaria Ag
SD BIOLINE Malaria Ag P.f/Pan
SD BIOLINE Malaria Ag P.f (HRP2/pLDH)
ParaHIT® - f (Device)
ParaHIT® - f (Dipstick)
diagnosticks MALARIA (Pan) Cassette
diagnosticks MALARIA (Pan/Pf) Cassette
diagnosticks MALARIA (Pan/Pv/Pf) Cassette
Clearview Malaria Combo
Clearview Malaria Pf
Clearview Malaria Dual Test Device
One Step Malaria P.f./Pan Whole Blood Test
One Step Malaria P.f Test
05FK40
05FK60
05FK90
55IC102-10
55IC101-10
MPNWBC1007.3
MPNFWBC1007.4
MPNVFC1007.5
VB11
VB01
VB20
W56-C
W37-C
pan pLDH
HRP2
HRP2
HRP2
HRP2
pan pLDH
HRP2
HRP2
HRP2
HRP2
HRP2
HRP2
HRP2
Malascan™ Device - Rapid test for Malaria Pf/Pan
50402025
HRP2
pan aldolase
Parabank™ Device - Rapid test for Malaria Pan
Parascreen™ Device -Rapid test for Malaria Pan/Pf
50301025
50310025
pan pLDH
HRP2
pan pLDH
pv pLDH
Pv pLDH
pf pLDH
pan pLDH
Pf pLDH
pan pLDH
pan pLDH
Aldolase
pan pLDH
pan pLDH
Pv pLDH
WHO Global Malaria Programme
Information note on recommended selection criteria for
procurement of malaria rapid diagnostic tests (RDTs)
- 20 December 2012 -
In view of the increasing demand of countries to scale-up malaria diagnostics following the largescale introduction of expensive antimalarial medicines, and the decreasing malaria trends in many
countries, there is a need for guidance in the selection of malaria rapid diagnostics that meet
international quality standards. This WHO note aims to provide information on both the criteria
which have been recommended for and additional considerations which play a role in the
procurement of malaria rapid diagnostic tests.
WHO policy on malaria diagnosis
WHO recommends parasitological confirmation of malaria through quality assured diagnosis in all
settings before treatment is started1. Treatment solely on the basis of clinical suspicion should only
be considered when a parasitological diagnosis is not accessible, i.e. not available within two hours
of patients presenting for treatment. Prompt diagnostic confirmation of malaria can be achieved
through quality microscopy or quality rapid diagnostic tests detecting Plasmodium falciparum
and/or Plasmodium vivax infections. In most countries both diagnostic methods are needed, as
microscopy and RDTs often play different roles according to the clinical situations or the setting.
WHO Malaria RDT Product Testing Programme
The heterogeneous diagnostic performance of more than 200 malaria RDTs currently available in
the market can undermine the confidence of health professionals in the accuracy of these tests.
The WHO Malaria RDT Product Testing Programme, coordinated by WHO/TDR and the Foundation
for Innovative New Diagnostics (FIND) and executed in collaboration with US Centers for Disease
Control and Prevention (CDC), provides comparative data on the performance of various RDTs
available in the market to assist in procurement. Since 2008, 168 products have been evaluated
over four rounds of WHO Malaria RDT Product Testing. This encompasses 128 unique products
and 29 product resubmissions (see Annex 1).
Each round of product testing begins with an invitation to all companies manufacturing under
"ISO-13485: Medical devices - Quality management systems - Requirements for regulatory
process" to submit up to 2-3 different RDTs for evaluation. The RDTs are evaluated against panels
of cultured P. falciparum parasites (n=20), panels of patient-derived P. falciparum (n~100) and P.
vivax (n~35) parasites, and a parasite-negative panel (n=100). The panel detection score (PDS)2,
key parameter of the assessment, is thus not a measure of RDT clinical sensitivity or positivity rate
against the panel but rather a combined measure of positivity rate along with inter-test and interlot consistency. In addition, thermal stability of the products is assessed after 2 months of storage
at elevated temperatures (35°C, 45°C) and 75% humidity, and ease of use is also evaluated. The
full report of results of all Rounds 1, 2, 3 and 4 is available at:
http://www.who.int/iris/bitstream/10665/77748/1/9789241504720_eng.pdf.
1
The WHO Guidelines for the treatment of malaria, 2nd edition 2010, are available at:
http://whqlibdoc.who.int/publications/2010/9789241547925_eng.pdf
2
The term ‘panel detection score’ (PDS) is a composite index of test positivity as well as of inter-test and inter-lot consistency in
performance. Panel detection score is not equivalent to sensitivity - see page 18 of the report of the Round 2 WHO malaria RDT product
testing for a detailed description of this parameter (http://whqlibdoc.who.int/publications/2010/9789241599467_eng.pdf ).
WHO selection criteria for the procurement of RDTs
Experts convened at the Inaugural Meeting of the Malaria Policy Advisory Committee (MPAC), held
in Geneva in early 2012, updated the WHO recommendations for the procurement of RDTs.
Products should be selected in line with the following set of criteria, based on the results of the
assessment of the WHO Malaria RDT Product Testing Programme3:
(A) For the detection of Plasmodium falciparum (Pf) in all transmission settings the panel
detection score (PDS) against Pf samples should be at least 75% at 200 parasites/µL.
(B) For the detection of Plasmodium vivax (Pv) in all transmission settings the panel
detection score (PDS) against Pv samples should be at least 75% at 200 parasites/µL.
(C) The false positive rate should be less than 10%.
(D) The invalid rate4 should be less than 5%.
FIND’s web-based interactive guide for the selection of malaria RDTs
Based on the results of Rounds 1-4 of the WHO Malaria RDT Product Testing Programme, FIND
has developed a web-based interactive guide which allows to select suitable malaria RDTs on the
basis of the following parameters: i) target malaria species, ii) minimum panel detection score for
P. falciparum at 200 and 2000 parasites/µL, iii) minimum panel detection score for P. vivax at 200
and 2000 parasites/µL, iv) maximum false positive rate, v) maximum invalid rate, vi) test format
and vii) heat stability. This guide is available at:
http://www.finddiagnostics.org/programs/malaria/find_activities/product_testing/malaria-rdtproduct-testing.
Additional considerations relevant for procurement of malaria RDTs
Stability requirements at temperatures of intended storage, transport and use
RDTs submitted to WHO for malaria RDT product testing are evaluated for positivity against a
single cultured P. falciparum isolate at 200 parasites/µL at baseline and after 60 days of incubation
at 35°C and 45°C. In this regard, it is recommended to select RDTs with high thermal stability for
areas with very high temperatures.
Ease of use and training requirements for the health workers
RDTs submitted to WHO for malaria RDT product testing are also evaluated for blood safety,
instruction quality, number of steps, time to results, blood transfer device, format and kit
completeness. Cassettes and cards are easier to use than dipsticks. For reasons of blood safety,
kits that include lancets and alcohol swabs are preferred over kits which do not contain these
items. Dipsticks are more suitable for settings with a laboratory facility.
3
The full report of the Round 4 of WHO Malaria RDT Product Testing Programme is available at:
http://www.who.int/iris/bitstream/10665/77748/1/9789241504720_eng.pdf.
4
Proportion of tests deemed invalid, i.e. without visible control band.
2
Price
After having considered all of the above factors, good procurement practice requires that the price
be taken into account.
Programmatic needs5
The aim of this note is not to recommend to national health authorities to immediately replace
with new tests the malaria RDTs which are already being deployed on a large scale. The diagnostic
performance of RDTs in the field is dependent on all the parameters listed above, as well as on the
effectiveness of training and supervision and on the functioning of the supply management system.
Particularly for programmes that are already implementing RDTs on a large-scale, the continued
deployment of the currently used tests may be appropriate until a decrease in malaria transmission
triggers the need for RDTs with better performance in detecting low-level parasitaemia. Plans to
replace RDTs should be developed carefully, taking into consideration the training and supervision
requirements to support the introduction of the new RDTs, as well as the production capacity and
expected lead time for deliveries from the suppliers of the new RDTs.
For a comprehensive guide to procurement of malaria RDTs extending beyond selection criteria
see the WHO manual on Good practices for selecting and procuring rapid diagnostic tests for
malaria6. This manual also includes practical advice on quantification, budgeting, tender technical
specifications, management of tenders and contracts, supply management up to the receipt of
goods at port of entry, monitoring of supplier performance and managing product variations.
WHO-FIND Lot Testing Programme
As the performance of individual products is likely to vary between lots over time, WHO
recommends that all RDT production lots be checked, either pre- or post-shipment, through a lottesting centre collaborating with the WHO-FIND Malaria RDT Product Testing Programme, as part
of good procurement practice. Currently, this service is free of charge through WHO-FIND’s two
affiliated laboratories7. Full information on WHO recommended procedures for RDT lot testing are
available at: http://www.wpro.who.int/sites/rdt/who_rdt_evaluation/lot_testing.htm.
5
This section is based on advice by WHO/GMP secretariat and not on recommendations of experts convened by a WHO Technical
Consultation.
6
The WHO manual on Good practices for selecting and procuring rapid diagnostic tests for malaria, Geneva, World Health Organization,
2011, is available at: http://whqlibdoc.who.int/publications/2011/9789241501125_eng.pdf.
7
The Research Institute for Tropical Medicine (RITM), Muntinlupa City, The Philippines, and the Institut Pasteur of Cambodia (IPC),
Phnom Penh, Cambodia.
3
Annex 1: Performance of Malaria RDTs in Rounds 1-4 of WHO Malaria RDT Product
Testing
The table of results reproduced below is extrapolated from the Table S1, published in the Results
of WHO Malaria RDT Product Testing: Summary Rounds 1-4 (available at
http://www.who.int/iris/bitstream/10665/77748/1/9789241504720_eng.pdf), listing the tested
products in alphabetical order by brand name, catalogue number and manufacturer. To this list,
the above WHO-recommended criteria for RDT procurement have been applied. Using the results
of WHO Malaria RDT Product Testing Programme Rounds 1-4 as the basis, a green box indicates
that the corresponding recommended criterion has been met, whereas a white box indicates that
this criterion has not been met.
Disclaimer:
The list below does not in any way imply an endorsement, certification, warranty of fitness or
recommendation by WHO of any company or product for any purpose, and does not imply
preference over products of a similar nature that are not mentioned. WHO furthermore does not
warrant that: (1) the list is complete and/or error free; and/or that (2) the products listed are of
acceptable quality, have obtained regulatory approval in any country, or that their use is otherwise
in accordance with the national laws and regulations of any country, including but not limited to
patent laws. Inclusion in the list does not furthermore imply any approval by WHO of the products
in question (which is the sole prerogative of national authorities).
The list is not an exhaustive list of malaria RDTs. The list reflects those products which have been
submitted for evaluation in Rounds 1-4 of the WHO Malaria RDT Product Testing Programme (full
report available at: http://www.who.int/iris/bitstream/10665/77748/1/9789241504720_eng.pdf).
Using the results of Rounds 1-4 as the basis, the criteria recommended for RDT procurement by
WHO have been applied to this list.
The fact that certain products are not included in the list means that they have not or not yet been
submitted for evaluation in the WHO Malaria RDT Product Testing Programme and does not
indicate anything in respect of such products' performance.
WHO will not accept any liability or responsibility whatsoever for any injury, death, loss, damage,
or other prejudice of any kind that may arise as a result of or in connection with the procurement,
distribution and use of any product whatsoever included in the list.
This list may not be used by manufacturers and suppliers for commercial or promotional purposes.
4
Performance of malaria RDTs in Rounds 1-4 of WHO Malaria RDT Product Testing Programme
Performance criteria:
Product
A: P. falciparum panel detection score > 75% at 200 parasites/µl
B: P. vivax panel detection score > 75% at 200 parasites/µl
C: False positive rate < 10%
D: Invalid rate < 5%
Catalogue
number*
Manufacturer
IMA-402
ABON Biopharm (Hangzhou) Co.
Ltd
ITP11002TC40
InTec Products, Inc.
ITP11002TC1
Re-tested
product
Performance criteria
RDT format
A
B
C
D
Pf only
ABON™ Malaria P.f. Rapid Test
Device (Whole Blood)
Advanced Quality™ One Step Malaria
P.f Test
Advanced Quality™Malaria (p.f)
POCT
Cassette
N/A
Cassette
N/A
InTec Products, Inc.
Cassette
N/A
IR016025
J. Mitra & Co. Pvt. Ltd.
Card
N/A
BIOCREDIT Malaria pf(HRP II)
HR0100
RapiGen Inc.
Cassette
N/A
BIONOTE MALARIA P.f. Ag Rapid Test
Kit
RG19-11
Bionote,Inc.
Cassette
N/A
CareStart™ Malaria HRP2 (Pf)
G0141
Access Bio, Inc.
Cassette
N/A
CareStart™ Malaria HRP2/pLDH Pf
test
G0181
Access Bio, Inc.
Cassette
N/A
Clearview® Malaria P.f.
VB01
Vision Biotech (Pty) Ltd
Cassette
N/A
MAL-190020
Core Diagnostics
Cassette
N/A
diagnosticks- Malaria (Pf) Cassette
KMFC6001
SSA Diagnostics & Biotech Systems
Cassette
N/A
diagnosticks- Malaria (Pf) Dipstick
KMFD6007
SSA Diagnostics & Biotech Systems
Dipstick
N/A
Advantage P.f. Malaria Card
Core™ Malaria Pf
√
√
5
Manufacturer
First Response® Malaria Ag HRP2
I13FRC30
Premier Medical Corporation Ltd.
FirstSign™ Malaria Pf
2100CB-25
Unimed International Inc.
--
Unimed International, Inc.
Cassette
N/A
58051
Human GmbH
Cassette
N/A
HR3023
HBI Co., Ltd.
Card
N/A
ML01
ICT Diagnostics
Cassette
N/A
IMMUNOQUICK CONTACT falciparum
0519K25
Biosynex
Cassette
N/A
Immunoquick Malaria Falciparum
0502_K25
Biosynex
Dipstick
N/A
IND ONE STEP MALARIA ANTIGEN P.f
535-11
IND Diagnostics Inc.
Cassette
N/A
Malaria Plasmodium falciparum Rapid
test Device (Whole blood)
IMA-402
ACON Laboratories, Inc.
Cassette
N/A
Maleriscan ® Malaria P.f Antigen Test
MAT-PF-50
Bhat Bio-Tech India (Pte.) Ltd.
Cassette
N/A
NanoSign Malaria Pf Ag
RMAF10
Bioland, Ltd
Cassette
N/A
One Step Malaria P.F Test (cassette)
522352
√
Cassette
N/A
One Step Malaria P.f Test
W37-C
√
Cassette
N/A
Cassette
N/A
Cassette
N/A
FirstSign™ – Malaria Pf Card Test
Hexagon Malaria
HiSens Malaria Ag Pf HRP2 Card
ICT Diagnostics Malaria P.f.
OnSight™ - Malaria Pf Test
OnSite Pf Ag Rapid Test
Blue Cross Bio-Medical (Beijing)
Co., Ltd.
Guangzhou Wondfo Biotech Co.
Ltd.
511-25-DB
Amgenix International, Inc.
R0114C
CTK Biotech, Inc.
Re-tested
product
Performance criteria
Catalogue
number*
Product
RDT format
A
Cassette
B
C
D
N/A
N/A
√
√
6
RDT format
Orchid Biomedical Systems
√
Cassette
N/A
30302025
Orchid Biomedical Systems
√
Dipstick
N/A
ParaHIT® - f (Device)
55IC102-50
Span Diagnostics Ltd.
√
Cassette
N/A
ParaHIT® -f (Dipstick)
55IC101-50
Span Diagnostics Ltd.
√
Dipstick
N/A
SD BIOLINE Malaria Ag P.f.
(HRP2/pLDH)k
05FK90
Standard Diagnostics Inc.
Cassette
N/A
SD BIOLINE Malaria Ag Pf
05FK50
Standard Diagnostics, Inc.
Cassette
N/A
A03-11-322
Artron Laboratories Inc.
Cassette
N/A
Paracheck® Pf Device- Rapid test for
P. falciparum Malaria Ver. 3
Paracheck® Pf Dipstick- Rapid test
for P. falciparum Malaria Ver. 3
TrustyTM Malaria Antigen P.f. test
Catalogue
number*
Manufacturer
30301025
Performance criteria
Re-tested
product
Product
A
B
C
D
Pf and Pan
ABON Malaria Pan/P.f. Rapid Test
Device
ABON™ Plus Malaria P.f/Pan Rapid
Test Device (Whole Blood)
IMA-B402
IMA-T402
ABON Biopharm (Hangzhou) Co.
Ltd.
ABON Biopharm (Hangzhou) Co.
Ltd
Cassette
Cassette
Advantage Mal Card
IR221025
J. Mitra & Co. Pvt. Ltd.
Card
AZOG Malaria pf (HRPII)/pf (LDH)/
(PAN-LDH) Antigen Detection Devicef
MFV-124F
AZOG, INC.
Cassette
Binax Now Malaria Test
IN660050
Inverness Medical Innovations,
Inc.
Card
RG19-08
Bionote,Inc.
Cassette
GO221
Access Bio, Inc.
Cassette
G0131
Access Bio, Inc.
Cassette
BIONOTE MALARIA P.f.& Pan Ag
Rapid Test Kit
CareStart™ Malaria/Pregnancy
Combo (pLDH/HRP2/HCG)
CareStart™ Malaria HRP2/pLDH
(Pf/PAN) COMBO
7
Catalogue
number*
Manufacturer
CareStart™ Malaria pLDH 3 Line Test
GO121
Access Bio, Inc.
Cassette
CareStart™ Malaria Screen
GO231
Access Bio, Inc.
Cassette
Clearview® Malaria Combo
VB11
Vision Biotech (Pty) Ltd
√
Cassette
Clearview® Malaria Dual Test Device
VB20
Vision Biotech (Pty) Ltd
√
Cassette
MAL-190024
Core Diagnostics Ltd.
Cassette
MPNFWBC1007.4
SSA Diagnostics & Biotech Systems
Cassette
RK MAL 001
Advy Chemical (Affiliate of Bharat
Serums & Vaccines Ltd. )
Cassette
I16FRC30
Premier Medical Corporation Ltd.
√
Cassette
2101 CB-25
Unimed International Inc.
√
Cassette
58024
Human GmbH
Cassette
HiSens Malaria Ag P.f/P.v Card
HR2823
HBI Co., Ltd.
Card
HiSens Malaria Ag Pf/Pv (HRP2/pLDH)
Card
HR2923
HBI Co., Ltd.
Card
Humasis Malaria P.f/Pan Antigen Test
AMAL-7025
Humasis, Co., Ltd.
Cassette
ICT Diagnostics Malaria Combo
ML02
ICT Diagnostics
ICT Diagnostics Malaria Dual
ML03
ICT Diagnostics
Cassette
0525K25
Biosynex
Cassette
Product
Core Malaria Pan Pf
diagnosticks MALARIA (Pan/Pf)
Cassette
EzDxTM Malaria Pan/Pf Rapid Test
Detection kit
First Response® Malaria pLDH/HRP2
Combo Test
FirstSign™ - ParaView (Pan+Pf)
Malaria Test
Hexagon Malaria Combi
IMMUNOQUICK CONTACT MALARIA
+4
Re-tested
product
√
Performance criteria
RDT format
A
B
C
D
Cassette
8
Catalogue
number*
Manufacturer
0506_K25
Biosynex
Dipstick
IND ONE STEP MALARIA ANTIGEN
P.f/Pan TEST
535-10
IND Diagnostics Inc.
Cassette
Malaria Pf/ PAN
GM004
Genomix Molecular Diagnostics
Pvt.Ltd.
Cassette
Malaria pf (HRP II)/PAN (pLDH)
Antigen Detection Test Device
1-13-101-1
United Biotech, Inc.
Cassette
Malaria P.F/Vivax
17211OP-25
Malaria Pan Test
MAL-W23N-001
Product
Immunoquick Malaria +4
Malaria pf (HRP II) / (PAN-pLDH)
Antigen Detection Test Device
Malaria pf (pLDH) / PAN-pLDH Test
Device
Malascan™ Device - Rapid test for
Malaria Pf/Pan
Maleriscan® Malaria P.f/PAN (Pv, Pm,
Po) 3 Line Antigen Test
MeDiPro Malaria Ag HRP2/pLDH
Combo
Re-tested
product
Diagnostics Automation/ Cortez
Diagnostics, Inc
Dima • Gesellschaft für
Diagnostika mbH
A
B
C
D
Cassette
Cassette
√
MFV-124R
AZOG, Inc.
MFV-124
AZOG, Inc.
50402025
Zephyr Biomedical Systems
MAT-PF/PAN-50
Bhat Bio-Tech India (Pte.) Ltd.
Cassette
IR-0051K
Formosa Biomedical Technology
Corp.
Cassette
NanoSign Malaria Pf/Pan Ag
RMAP10
Bioland, Ltd
NanoSign Malaria Pf/Pv Ag -
RMAD10
Bioland, Ltd
Cassette
One Step Malaria Antigen Strip
820-1
IND Diagnostic Inc.
Dipstick
One Step Malaria P.f/Pan Test
W56-C
Guangzhou Wondfo Biotech Co.
Ltd.
536-25DB
Amgenix International, Inc.
OnSight™ – ParaQuick (Pan, Pf) Test
Performance criteria
RDT format
Cassette
Cassette
√
√
√
Cassette
Cassette
Dipstick
Cassette
9
Catalogue
number*
Manufacturer
Re-tested
product
RDT format
OnSite Pf/Pan Malaria Ag Rapid Test
R0113C
CTK Biotech, Inc.
√
Cassette
OptiMAL-IT
710024
Diamed - A Division of Bio-Rad
√
Hybrid
ParaHIT - Total Ver. 1.0 (Dipstick)
55IC203-10
Span Diagnostics Ltd.
Dipstick
ParaHIT - Total Ver. 1.0 (Device)
55IC204-10
Span Diagnostics Ltd.
Cassette
ParaHIT® total (dipstick)
55IC201-10
Span Diagnostics Ltd
Dipstick
25989
Span Diagnostics Ltd.
Cassette
50310025
Zephyr Biomedical Systems
Quickstick Malaria Antigen Test
--
Innovatek Medical Inc.
SD BIOLINE Malaria Ag P.f/Pan
05FK60
Standard Diagnostics Inc.
SD BIOLINE Malaria Ag Pf/ Pan
05FK66
Standard Diagnostics Inc.
SD BIOLINE Malaria Ag
05FK40
Standard Diagnostics Inc.
IMA-T402
ACON Biotech (Hangzhou) Co. Ltd.
Cassette
ITP11003 TC40
InTec Products, Inc.
Cassette
Advantage Malaria Card
IR211025
J. Mitra & Co. Pvt. Ltd.
Card
BIONOTE MALARIA P.f.& P.v. Ag
Rapid Test Kit
RG19-12
Bionote,Inc.
Cassette
Product
Parahit-Total Device Rapid test for P.
falciparum and Pan malarial species
Parascreen™ Device - Rapid test for
Malaria Pan/Pf
Surestep™ Easy Malaria Pf/Pan Rapid
Test Device
√
Performance criteria
A
B
C
D
Cassette
Dipstick
√
Cassette
√
Cassette
Pf and Pv
Advanced Quality™ One Step Malaria
P.f/P.v Tri-Line Test
10
Re-tested
product
RDT format
Access Bio, Inc.
√
Cassette
G0171
Access Bio, Inc.
√
Cassette
Core™ Malaria Pv/Pf
MAL-190022
Core Diagnostics
Cassette
diagnosticks- Malaria (Pv/Pf) Cassette
KMVFC6002
SSA Diagnostics & Biotech Systems
Cassette
50300025
Zephyr Biomedicals
2102CB-25
Unimed International, Inc.
Cassette
HR3123
HBI Co., Ltd.
Cassette
HR3323
HBI Co., Ltd.
Cassette
AMFV-7025
Humasis, Co., Ltd.
Cassette
GM002
Genomix Molecular Diagnostics
Pvt.Ltd.
Cassette
1-13-101-3
United Biotech, Inc.
Cassette
MFV-124V
AZOG, Inc.
Cassette
MAT-50
Bhat Bio-Tech India (P) Ltd
Cassette
M161
Medisensor, Inc.
Cassette
M171
Medisensor, Inc.
Cassette
537-25-DB
Amgenix International, Inc.
Cassette
Product
CareStart™ Malaria HRP2/PLDH
(Pf/Pv) COMBO
CareStart™ Malaria HRP2/PLDH
(Pf/VOM) COMBO
Falcivax Rapid Test for Malaria Pv/Pf
(device)
FirstSign™ – ParaView-2 (Pv + Pf)
Card Test
HiSens Malaria Ag P.f/P.v Combo
Card
HiSens Malaria Ag P.f/VOM Combo
Card
Humasis Malaria P.f/P.v Antigen Test
Malaria Pf/Pv
Malaria pf (HRP II) / pv (pLDH)
Antigen Detection Test Device
Malaria pf (HRP II) / pv (pLDH)
Antigen Detection Test Device
Maleriscan® Malaria Pf/Pv
Medisensor Malaria HRP2/pLDH
(Pf/Pv) COMBO
Medisensor Malaria HRP2/pLDH
(Pf/VOM) COMBO
OnSight™ - ParaQuick-2 (Pv,Pf)
Malaria Test
Catalogue
number*
Manufacturer
G0161
√
Performance criteria
A
B
C
D
Cassette
11
Catalogue
number*
Manufacturer
R0112C
CTK Biotech, Inc.
523352
Blue Cross Bio-Medical (Beijing)
Co., Ltd.
Cassette
G0161
Access Bio Ethiopia
Cassette
G0171
Access Bio Ethiopia
Cassette
MAL-PFVCAS/25(100)
Hema Diagnostic Systems, LLC
Cassette
SD BIOLINE Malaria Ag Pf/ Pf/ Pv
05FK100
Standard Diagnostics Inc.
Cassette
SD BIOLINE Malaria Ag Pf/Pv
05FK80
Standard Diagnostics, Inc.
Cassette
A03-12-322
Artron Laboratories Inc.
Cassette
MAL-190026
Core Diagnostics
Cassette
MPNVFC1007.5
SSA Diagnostics & Biotech Systems
Cassette
2103 CB-25
Unimed International Inc.
Cassette
50320025
Zephyr Biomedicals
Cassette
Advantage Pan Malaria Card
IR013025
J. Mitra & Co. Pvt. Ltd.
Cassette
AZOG hCG Malaria Detection Test
Device
MPT-124
AZOG, INC.
Cassette
Product
OnSite Malaria Pf/Pv Ag Rapid Test
One Step Malaria P.F/P.V Test
(Cassette)
ParaCare Malaria HRP2/pLDH (Pf/Pv)
COMBO
ParaCare Malaria HRP2/pLDH
(Pf/VOM) COMBO
RAPID 1-2-3® HEMA CASSETTE
MALARIA PF/PV TEST
TrustyTM Malaria Antigen P.f./p.v. test
Re-tested
product
RDT format
√
Cassette
Performance criteria
A
B
C
D
Pf, Pv and Pan
Core™ Malaria Pan/Pv/Pf
diagnosticks MALARIA (Pan/Pv/Pf)
Cassette
FirstSign™ - ParaView-3 (Pan+Pv+Pf)
Malaria Test
Paramax-3 Rapid Test for Malaria
Pan/Pv/Pf (device)
Pan only
12
Product
CareStart™ Malaria pLDH (PAN)
Clearview® Malaria pLDH
diagnosticks MALARIA (Pan) Cassette
First Response® Malaria Ag pLDH
FirstSign™ - PanCheck (Pan) Malaria
Test
OnSight™ - PanScreen (Pan) Malaria
Test
Parabank™ Device - Rapid test for
Malaria Pan
Catalogue
number*
Manufacturer
Re-tested
product
G0111
Access Bio, Inc.
70884025
Orgenics Ltd. (Inverness Medical
Innovations)
MPNWBC1007.3
SSA Diagnostics & Biotech Systems
Cassette
I12FRC30
Premier Medical Corporation Ltd.
Cassette
2104 CB-25
Unimed International Inc.
Cassette
539-25-DB
Amgenix International, Inc.
Cassette
50301025
Zephyr Biomedical Systems
05FK70
Standard Diagnostics, Inc.
Performance criteria
RDT format
A
B
C
D
Cassette
√
√
Cassette
Cassette
Pv only
SD BIOLINE Malaria Ag Pv
*
N/A
Pan
Pf
Pv
Cassette
N/A
Some production may include different catalogue numbers for different box sizes; contact manufacturers for detailed information.
Results not available
All Plasmodium species
Plasmodium falciparum
Plasmodium vivax
13