Improving adherence to severe malaria treatment guidelines in children at a Ugandan regional hospital: assessment of a quality improvement initiative
Abstract Background Malaria is the leading cause of hospitalizations and death in Uganda, particularly in children under the age of five. Studies have shown that adherence to the World Health Organization (WHO) guidelines for the management of severe malaria reduces mortality in hospitalized childre...
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ftdoajarticles:oai:doaj.org/article:247915a744884188914d880e92642a84 2024-09-09T19:28:26+00:00 Improving adherence to severe malaria treatment guidelines in children at a Ugandan regional hospital: assessment of a quality improvement initiative Cynthia A. Moffitt Peter Olupot-Olupot Joan Wamulugwa Julian Abeso Jennifer A. Muszynski Nicole O’Brien 2024-08-01T00:00:00Z https://doi.org/10.1186/s12936-024-05076-w https://doaj.org/article/247915a744884188914d880e92642a84 EN eng BMC https://doi.org/10.1186/s12936-024-05076-w https://doaj.org/toc/1475-2875 doi:10.1186/s12936-024-05076-w 1475-2875 https://doaj.org/article/247915a744884188914d880e92642a84 Malaria Journal, Vol 23, Iss 1, Pp 1-11 (2024) Malaria Severe malaria Guidelines Case management Adherence Uganda Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2024 ftdoajarticles https://doi.org/10.1186/s12936-024-05076-w 2024-08-19T14:56:42Z Abstract Background Malaria is the leading cause of hospitalizations and death in Uganda, particularly in children under the age of five. Studies have shown that adherence to the World Health Organization (WHO) guidelines for the management of severe malaria reduces mortality in hospitalized children. This study aimed to determine the impact of targeted interventions on adherence to the WHO severe malaria treatment guidelines in children at a Ugandan hospital as part of a quality improvement initiative. Methods Interventions included workflow changes, such as obtaining patient blood samples for diagnostic testing by the admitting healthcare provider as well as utilizing patient caregivers to assist nursing staff in timing medications. An additional intervention was the use of an admission checklist sticker. The post-intervention sample was compared to the baseline assessment. The primary outcome was the proportion of patients receiving care consistent with all aspects of the WHO guidelines. Secondary outcomes included the proportion of patients receiving malaria diagnostic testing, those receiving at least 3 doses of artesunate, the timely administration of artesunate, and adherence to other guideline components. Statistical analyses were conducted using GraphPad PRISM 9.0. Comparisons between groups were analysed using Chi-square or Fisher’s exact test for categorical variables and Mann–Whitney test for continuous variables. Results The post-intervention group included 230 patients with a median age of 5 years [4–8], and 58% of patients were male. Adherence to all aspects of the WHO guidelines was achieved in 10% of patients in the post-intervention group compared to 3% of patients in the baseline (P = 0.007). Appropriate malaria diagnostic testing was performed in 85% of patients post-intervention compared to 66% of patients in the baseline (P < 0.0001). Patients in the post-intervention group were more likely to receive the minimum 3 doses of artesunate (86%) than in the baseline (74%) (P = 0.008). ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 23 1 |
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ftdoajarticles |
language |
English |
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Malaria Severe malaria Guidelines Case management Adherence Uganda Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Malaria Severe malaria Guidelines Case management Adherence Uganda Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Cynthia A. Moffitt Peter Olupot-Olupot Joan Wamulugwa Julian Abeso Jennifer A. Muszynski Nicole O’Brien Improving adherence to severe malaria treatment guidelines in children at a Ugandan regional hospital: assessment of a quality improvement initiative |
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Malaria Severe malaria Guidelines Case management Adherence Uganda Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Malaria is the leading cause of hospitalizations and death in Uganda, particularly in children under the age of five. Studies have shown that adherence to the World Health Organization (WHO) guidelines for the management of severe malaria reduces mortality in hospitalized children. This study aimed to determine the impact of targeted interventions on adherence to the WHO severe malaria treatment guidelines in children at a Ugandan hospital as part of a quality improvement initiative. Methods Interventions included workflow changes, such as obtaining patient blood samples for diagnostic testing by the admitting healthcare provider as well as utilizing patient caregivers to assist nursing staff in timing medications. An additional intervention was the use of an admission checklist sticker. The post-intervention sample was compared to the baseline assessment. The primary outcome was the proportion of patients receiving care consistent with all aspects of the WHO guidelines. Secondary outcomes included the proportion of patients receiving malaria diagnostic testing, those receiving at least 3 doses of artesunate, the timely administration of artesunate, and adherence to other guideline components. Statistical analyses were conducted using GraphPad PRISM 9.0. Comparisons between groups were analysed using Chi-square or Fisher’s exact test for categorical variables and Mann–Whitney test for continuous variables. Results The post-intervention group included 230 patients with a median age of 5 years [4–8], and 58% of patients were male. Adherence to all aspects of the WHO guidelines was achieved in 10% of patients in the post-intervention group compared to 3% of patients in the baseline (P = 0.007). Appropriate malaria diagnostic testing was performed in 85% of patients post-intervention compared to 66% of patients in the baseline (P < 0.0001). Patients in the post-intervention group were more likely to receive the minimum 3 doses of artesunate (86%) than in the baseline (74%) (P = 0.008). ... |
format |
Article in Journal/Newspaper |
author |
Cynthia A. Moffitt Peter Olupot-Olupot Joan Wamulugwa Julian Abeso Jennifer A. Muszynski Nicole O’Brien |
author_facet |
Cynthia A. Moffitt Peter Olupot-Olupot Joan Wamulugwa Julian Abeso Jennifer A. Muszynski Nicole O’Brien |
author_sort |
Cynthia A. Moffitt |
title |
Improving adherence to severe malaria treatment guidelines in children at a Ugandan regional hospital: assessment of a quality improvement initiative |
title_short |
Improving adherence to severe malaria treatment guidelines in children at a Ugandan regional hospital: assessment of a quality improvement initiative |
title_full |
Improving adherence to severe malaria treatment guidelines in children at a Ugandan regional hospital: assessment of a quality improvement initiative |
title_fullStr |
Improving adherence to severe malaria treatment guidelines in children at a Ugandan regional hospital: assessment of a quality improvement initiative |
title_full_unstemmed |
Improving adherence to severe malaria treatment guidelines in children at a Ugandan regional hospital: assessment of a quality improvement initiative |
title_sort |
improving adherence to severe malaria treatment guidelines in children at a ugandan regional hospital: assessment of a quality improvement initiative |
publisher |
BMC |
publishDate |
2024 |
url |
https://doi.org/10.1186/s12936-024-05076-w https://doaj.org/article/247915a744884188914d880e92642a84 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 23, Iss 1, Pp 1-11 (2024) |
op_relation |
https://doi.org/10.1186/s12936-024-05076-w https://doaj.org/toc/1475-2875 doi:10.1186/s12936-024-05076-w 1475-2875 https://doaj.org/article/247915a744884188914d880e92642a84 |
op_doi |
https://doi.org/10.1186/s12936-024-05076-w |
container_title |
Malaria Journal |
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23 |
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1 |
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1809897724894511104 |