Low practical knowledge but high willingness to use of rapid diagnostic tests for malaria by healthcare workers in Republic of Congo

Background : Malaria rapid diagnostic tests (mRDTs) are essential for early detection and effective management of malaria, but their success depends on healthcare workers’ (HCWs) knowledge, attitudes, and willingness to use them. This study assessed these factors to guide malaria case management strategies in the Republic of Congo. Methods : A descriptive cross-sectional study was conducted from November 2024 to February 2025 across nine health districts in Brazzaville. Thirty-six (36) randomly selected public and private primary healthcare facilities participated, with 211 HCWs involved in malaria diagnosis. Data were collected using a semi-structured questionnaire. Knowledge, attitude and pratice levels were classified as good (≥75%), intermediate (50–74.9%), or insufficient (<50%). Results Among participants, 96% reported using mRDTs, though only 36% had received specific training. General malaria knowledge was low, with just 9% scoring good. Most (90%) had poor understanding of target antigens and diagnostic procedures. However, 97% and 59% perceived mRDTs as easy to use and reliable, respectively. In practice, 85.8% used both mRDTs and microscopy, but only 7.6% followed national guidelines. Following a negative mRDT in symptomatic patients, 39% requested microscopy, and 27% prescribed antimalarials based on clinical suspicion. No significant associations were found between knowledge, attitudes or practices and demographic or professional characteristics. Conclusion Although mRDT usage is HCWs in Brazzaville, significant gaps persist in knowledge, training, and compliance with national diagnostic protocols. Enhanced training and policy enforcement are needed to strengthen malaria case management in the Republic of Congo.