Malaria case-management under artemether-lumefantrine treatment policy in Uganda
Abstract Background Case-management with artemether-lumefantrine (AL) is one of the key strategies to control malaria in many African countries. Yet, the reports on translation of AL implementation activities into clinical practice are scarce. Here the quality of AL case-management is reported from...
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ftdoajarticles:oai:doaj.org/article:b99de09c6a6d4e7ba936365293e34c7e 2023-05-15T15:17:53+02:00 Malaria case-management under artemether-lumefantrine treatment policy in Uganda Ssekitooleko James Nankabirwa Joan Tibenderana James K Zurovac Dejan Njogu Julius N Rwakimari John B Meek Sylvia Talisuna Ambrose Snow Robert W 2008-09-01T00:00:00Z https://doi.org/10.1186/1475-2875-7-181 https://doaj.org/article/b99de09c6a6d4e7ba936365293e34c7e EN eng BMC http://www.malariajournal.com/content/7/1/181 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-7-181 1475-2875 https://doaj.org/article/b99de09c6a6d4e7ba936365293e34c7e Malaria Journal, Vol 7, Iss 1, p 181 (2008) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2008 ftdoajarticles https://doi.org/10.1186/1475-2875-7-181 2022-12-31T08:55:40Z Abstract Background Case-management with artemether-lumefantrine (AL) is one of the key strategies to control malaria in many African countries. Yet, the reports on translation of AL implementation activities into clinical practice are scarce. Here the quality of AL case-management is reported from Uganda; approximately one year after AL replaced combination of chloroquine and sulphadoxine-pyrimethamine (CQ+SP) as recommended first line treatment for uncomplicated malaria. Methods A cross-sectional survey, using a range of quality of care assessment tools, was undertaken at all government and private-not-for-profit facilities in four Ugandan districts. Main outcome measures were AL prescribing, dispensing and counseling practices in comparison with national guidelines, and factors influencing health workers decision to 1) treat for malaria, and 2) prescribe AL. Results 195 facilities, 232 health workers and 1,763 outpatient consultations were evaluated. Of 1,200 patients who needed treatment with AL according to guidelines, AL was prescribed for 60%, CQ+SP for 14%, quinine for 4%, CQ for 3%, other antimalarials for 3%, and 16% of patients had no antimalarial drug prescribed. AL was prescribed in the correct dose for 95% of patients. Only three out of seven AL counseling and dispensing tasks were performed for more than 50% of patients. Patients were more likely to be treated for malaria if they presented with main complaint of fever (OR = 5.22; 95% CI: 3.61–7.54) and if they were seen by supervised health workers (OR = 1.63; 95% CI: 1.06–2.50); however less likely if they were treated by more qualified health workers (OR = 0.61; 95% CI: 0.40–0.93) and presented with skin problem (OR = 0.29; 95% CI: 0.15–0.55). AL was more likely prescribed if the appropriate weight-specific AL pack was in stock (OR = 6.15; 95% CI: 3.43–11.05) and when CQ was absent (OR = 2.16; 95% CI: 1.09–4.28). Routine AL implementation activities were not associated with better performance. Conclusion Although the use of AL was predominant ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 7 1 |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
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 Ssekitooleko James Nankabirwa Joan Tibenderana James K Zurovac Dejan Njogu Julius N Rwakimari John B Meek Sylvia Talisuna Ambrose Snow Robert W Malaria case-management under artemether-lumefantrine treatment policy in Uganda |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Case-management with artemether-lumefantrine (AL) is one of the key strategies to control malaria in many African countries. Yet, the reports on translation of AL implementation activities into clinical practice are scarce. Here the quality of AL case-management is reported from Uganda; approximately one year after AL replaced combination of chloroquine and sulphadoxine-pyrimethamine (CQ+SP) as recommended first line treatment for uncomplicated malaria. Methods A cross-sectional survey, using a range of quality of care assessment tools, was undertaken at all government and private-not-for-profit facilities in four Ugandan districts. Main outcome measures were AL prescribing, dispensing and counseling practices in comparison with national guidelines, and factors influencing health workers decision to 1) treat for malaria, and 2) prescribe AL. Results 195 facilities, 232 health workers and 1,763 outpatient consultations were evaluated. Of 1,200 patients who needed treatment with AL according to guidelines, AL was prescribed for 60%, CQ+SP for 14%, quinine for 4%, CQ for 3%, other antimalarials for 3%, and 16% of patients had no antimalarial drug prescribed. AL was prescribed in the correct dose for 95% of patients. Only three out of seven AL counseling and dispensing tasks were performed for more than 50% of patients. Patients were more likely to be treated for malaria if they presented with main complaint of fever (OR = 5.22; 95% CI: 3.61–7.54) and if they were seen by supervised health workers (OR = 1.63; 95% CI: 1.06–2.50); however less likely if they were treated by more qualified health workers (OR = 0.61; 95% CI: 0.40–0.93) and presented with skin problem (OR = 0.29; 95% CI: 0.15–0.55). AL was more likely prescribed if the appropriate weight-specific AL pack was in stock (OR = 6.15; 95% CI: 3.43–11.05) and when CQ was absent (OR = 2.16; 95% CI: 1.09–4.28). Routine AL implementation activities were not associated with better performance. Conclusion Although the use of AL was predominant ... |
format |
Article in Journal/Newspaper |
author |
Ssekitooleko James Nankabirwa Joan Tibenderana James K Zurovac Dejan Njogu Julius N Rwakimari John B Meek Sylvia Talisuna Ambrose Snow Robert W |
author_facet |
Ssekitooleko James Nankabirwa Joan Tibenderana James K Zurovac Dejan Njogu Julius N Rwakimari John B Meek Sylvia Talisuna Ambrose Snow Robert W |
author_sort |
Ssekitooleko James |
title |
Malaria case-management under artemether-lumefantrine treatment policy in Uganda |
title_short |
Malaria case-management under artemether-lumefantrine treatment policy in Uganda |
title_full |
Malaria case-management under artemether-lumefantrine treatment policy in Uganda |
title_fullStr |
Malaria case-management under artemether-lumefantrine treatment policy in Uganda |
title_full_unstemmed |
Malaria case-management under artemether-lumefantrine treatment policy in Uganda |
title_sort |
malaria case-management under artemether-lumefantrine treatment policy in uganda |
publisher |
BMC |
publishDate |
2008 |
url |
https://doi.org/10.1186/1475-2875-7-181 https://doaj.org/article/b99de09c6a6d4e7ba936365293e34c7e |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 7, Iss 1, p 181 (2008) |
op_relation |
http://www.malariajournal.com/content/7/1/181 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-7-181 1475-2875 https://doaj.org/article/b99de09c6a6d4e7ba936365293e34c7e |
op_doi |
https://doi.org/10.1186/1475-2875-7-181 |
container_title |
Malaria Journal |
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7 |
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1 |
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1766348143263219712 |