Background. The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional but can lead to overdiagnosis of malaria, delay of appropriate treatment, overprescription of antimalarials, and drug resistance. Routine use of diagnostic tests can address many of these concerns. Though treatment is often procured from retailers, there is low availability of rapid diagnostic tests for malaria (MRDTs), a simple, inexpensive, and accurate diagnostic solution. We know little about the challenges to expanding access to diagnostics through these outlets. Methods. To understand the perceptions of the benefits and challenges to selling rapid diagnostic tests for malaria, we conducted focus group discussions with antimalarial retailers who serve the residents of the Webuye Health and Demographic Surveillance Site in western Kenya. Results. Medicine retailers perceived MRDTs to be beneficial to their customers and businesses but also included cost, fear of the tests, risks of self-treatment, and regulatory concerns among the challenges to using and selling MRDTs. Conclusion. MRDTs represent a viable approach to increase access to malaria diagnostic testing. Medicine retailers are eager for MRDTs to be made available to them. However, certain challenges remain to implementation in retail outlets and should be addressed in advance. 1. Background Malaria contributes significantly to the global burden of disease, causing an estimated 0.5 to 2.5 million deaths each year [1]. To reduce the disease burden, international organizations advocate treatment for malaria to be administered within 24 hours of the first symptoms of the disease [2]. However, several signs and symptoms associated with malaria are shared by a host of other diseases, such as influenza and pneumonia [3]. As a result, clinical diagnosis has poor specificity for malaria [4], often resulting in overdiagnosis of malaria, overprescription of costly antimalarials [5], and underdiagnosis or delayed treatment of the true cause of fever [3, 6]. Improving access to accurate parasitological diagnosis is now of critical concern for malarial control [7]. Microscopic examination of stained blood films remains the gold standard for diagnosing malaria, but microscopy requires trained laboratory staff, costly equipment, a constant supply of reagents, and quality control and supervisory systems [8, 9]. Compared to microscopic testing, rapid diagnostic tests for malaria (MRDTs) are easy to use, do not require any specialized equipment, and are relatively inexpensive, with a
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