Use of RDTs to improve malaria diagnosis and fever case management at primary health care facilities in Uganda
Abstract Background Early and accurate diagnosis of malaria followed by prompt treatment reduces the risk of severe disease in malaria endemic regions. Presumptive treatment of malaria is widely practised where microscopy or rapid diagnostic tests (RDTs) are not readily available. With the introduct...
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ftdoajarticles:oai:doaj.org/article:171ae7b44d9d4bfa947ba403fefa7e1b 2023-05-15T15:18:24+02:00 Use of RDTs to improve malaria diagnosis and fever case management at primary health care facilities in Uganda Nabakooza Jane Counihan Helen Nakanjako Damalie Asiimwe Caroline Kyabayinze Daniel J Tibenderana James K 2010-07-01T00:00:00Z https://doi.org/10.1186/1475-2875-9-200 https://doaj.org/article/171ae7b44d9d4bfa947ba403fefa7e1b EN eng BMC http://www.malariajournal.com/content/9/1/200 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-9-200 1475-2875 https://doaj.org/article/171ae7b44d9d4bfa947ba403fefa7e1b Malaria Journal, Vol 9, Iss 1, p 200 (2010) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2010 ftdoajarticles https://doi.org/10.1186/1475-2875-9-200 2022-12-30T22:16:45Z Abstract Background Early and accurate diagnosis of malaria followed by prompt treatment reduces the risk of severe disease in malaria endemic regions. Presumptive treatment of malaria is widely practised where microscopy or rapid diagnostic tests (RDTs) are not readily available. With the introduction of artemisinin-based combination therapy (ACT) for treatment of malaria in many low-resource settings, there is need to target treatment to patients with parasitologically confirmed malaria in order to improve quality of care, reduce over consumption of anti-malarials, reduce drug pressure and in turn delay development and spread of drug resistance. This study evaluated the effect of malaria RDTs on health workers' anti-malarial drug (AMD) prescriptions among outpatients at low level health care facilities (LLHCF) within different malaria epidemiological settings in Uganda. Methods All health workers (HWs) in 21 selected intervention (where RDTs were deployed) LLHF were invited for training on the use RDTs. All HWs were trained to use RDTs for parasitological diagnosis of all suspected malaria cases irrespective of age. Five LLHCFs with clinical diagnosis (CD only) were included for comparison. Subsequently AMD prescriptions were compared using both a 'pre - post' and 'intervention - control' analysis designs. In-depth interviews of the HWs were conducted to explore any factors that influence AMD prescription practices. Results A total of 166,131 out-patient attendances (OPD) were evaluated at 21 intervention LLHCFs. Overall use of RDTs resulted in a 38% point reduction in AMD prescriptions. There was a two-fold reduction (RR 0.62, 95% CI 0.55-0.70) in AMD prescription with the greatest reduction in the hypo-endemic setting (RR 0.46 95% CI 0.51-0.53) but no significant change in the urban setting (RR1.01, p-value = 0.820). Over 90% of all eligible OPD patients were offered a test. An average of 30% (range 25%-35%) of the RDT-negative fever patients received AMD prescriptions. When the test result was negative, ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 9 1 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Nabakooza Jane Counihan Helen Nakanjako Damalie Asiimwe Caroline Kyabayinze Daniel J Tibenderana James K Use of RDTs to improve malaria diagnosis and fever case management at primary health care facilities in Uganda |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Early and accurate diagnosis of malaria followed by prompt treatment reduces the risk of severe disease in malaria endemic regions. Presumptive treatment of malaria is widely practised where microscopy or rapid diagnostic tests (RDTs) are not readily available. With the introduction of artemisinin-based combination therapy (ACT) for treatment of malaria in many low-resource settings, there is need to target treatment to patients with parasitologically confirmed malaria in order to improve quality of care, reduce over consumption of anti-malarials, reduce drug pressure and in turn delay development and spread of drug resistance. This study evaluated the effect of malaria RDTs on health workers' anti-malarial drug (AMD) prescriptions among outpatients at low level health care facilities (LLHCF) within different malaria epidemiological settings in Uganda. Methods All health workers (HWs) in 21 selected intervention (where RDTs were deployed) LLHF were invited for training on the use RDTs. All HWs were trained to use RDTs for parasitological diagnosis of all suspected malaria cases irrespective of age. Five LLHCFs with clinical diagnosis (CD only) were included for comparison. Subsequently AMD prescriptions were compared using both a 'pre - post' and 'intervention - control' analysis designs. In-depth interviews of the HWs were conducted to explore any factors that influence AMD prescription practices. Results A total of 166,131 out-patient attendances (OPD) were evaluated at 21 intervention LLHCFs. Overall use of RDTs resulted in a 38% point reduction in AMD prescriptions. There was a two-fold reduction (RR 0.62, 95% CI 0.55-0.70) in AMD prescription with the greatest reduction in the hypo-endemic setting (RR 0.46 95% CI 0.51-0.53) but no significant change in the urban setting (RR1.01, p-value = 0.820). Over 90% of all eligible OPD patients were offered a test. An average of 30% (range 25%-35%) of the RDT-negative fever patients received AMD prescriptions. When the test result was negative, ... |
format |
Article in Journal/Newspaper |
author |
Nabakooza Jane Counihan Helen Nakanjako Damalie Asiimwe Caroline Kyabayinze Daniel J Tibenderana James K |
author_facet |
Nabakooza Jane Counihan Helen Nakanjako Damalie Asiimwe Caroline Kyabayinze Daniel J Tibenderana James K |
author_sort |
Nabakooza Jane |
title |
Use of RDTs to improve malaria diagnosis and fever case management at primary health care facilities in Uganda |
title_short |
Use of RDTs to improve malaria diagnosis and fever case management at primary health care facilities in Uganda |
title_full |
Use of RDTs to improve malaria diagnosis and fever case management at primary health care facilities in Uganda |
title_fullStr |
Use of RDTs to improve malaria diagnosis and fever case management at primary health care facilities in Uganda |
title_full_unstemmed |
Use of RDTs to improve malaria diagnosis and fever case management at primary health care facilities in Uganda |
title_sort |
use of rdts to improve malaria diagnosis and fever case management at primary health care facilities in uganda |
publisher |
BMC |
publishDate |
2010 |
url |
https://doi.org/10.1186/1475-2875-9-200 https://doaj.org/article/171ae7b44d9d4bfa947ba403fefa7e1b |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 9, Iss 1, p 200 (2010) |
op_relation |
http://www.malariajournal.com/content/9/1/200 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-9-200 1475-2875 https://doaj.org/article/171ae7b44d9d4bfa947ba403fefa7e1b |
op_doi |
https://doi.org/10.1186/1475-2875-9-200 |
container_title |
Malaria Journal |
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9 |
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1 |
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1766348597083766784 |