Demand-related factors influencing caregivers’ awareness of malaria tests and health workers’ testing practices, in Makarfi, Nigeria

• Published in: Malaria Journal
• Main Authors: Olufemi Ajumobi, Kabir Sabitu, IkeOluwapo Ajayi, Patrick Nguku, Joy Ufere, Peter Wasswa, Chinwoke Isiguzo, Jennifer Anyanti, Jenny Liu
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2017
• Subjects: Malaria testing; Healthcare workers; Children; Nigeria; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-017-2138-8; https://doaj.org/article/a1ba17ffd5d2425ab416bc606d874585

Abstract Background Despite the World Health Organization’s recommendation of malaria test-treat strategy, which is the treatment of parasitological confirmed malaria cases with anti-malarials, presumptive diagnosis of malaria remains fairly common in Nigeria. The reasons for this have not been established in Makarfi, Nigeria, despite the high burden of malaria in the area. A study was conducted among caregivers of febrile children less than 5 years presenting for treatment to understand their awareness of malaria diagnostic testing and being offered testing by clinicians, the determinants of these outcomes, and caregivers’ perspectives of health workers’ testing practices. Methods Using mixed-methods, data was combined from sub-analysis of cross-sectional survey data (n = 295) and focus group discussions (n = 4) with caregivers conducted in Makarfi General Hospital (Kaduna State, Nigeria) and surrounding communities in 2011. Bivariate and multivariate analysis of the quantitative survey data was conducted to examine associations of caregivers’ sociodemographic characteristics with testing awareness and having ever been offered testing. Transcripts from focus group discussions (FGD) were analysed for emerging themes related to caregivers’ perspectives on malaria testing. Results Among surveyed caregivers who were predominantly female (81.7%), not formally educated (72.5%), and were housewives (68.8%); only 5.3% were aware of any diagnostic testing for malaria, and only 4.3% had ever been offered a malaria test by a health worker. Having at least a primary level education (adjusted odds ratio [aOR] 20.3, 95% CI 4.5–92.1) and living within 5 km of the hospital (aOR 4.3, 95% CI 1.5–12.5) were determinants of awareness of malaria testing. Also, these were determinants of previously having been offered a test (aOR 9.9, 95% CI 2.1–48.7; and aOR 4.0, 95% CI 1.1–14.7). FGD showed many caregivers believed that malaria testing was for severe illness only, and that proximity to a health facility and cost of treatment ...