Do clinicians in areas of declining malaria transmission adhere to malaria diagnosis guidelines? A cross-sectional study from Kampala, Uganda
Abstract Background Uganda's clinical management guidelines recommend a malaria laboratory test in all patients presenting with fever (history of fever or an axillary temperature ≥ 37.5 °C), and only those with a positive test receive anti-malarial treatment. However, the current practice in ar...
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ftdoajarticles:oai:doaj.org/article:fbc6fa9b52ea44f3af74e65132cff1a6 2023-05-15T15:15:16+02:00 Do clinicians in areas of declining malaria transmission adhere to malaria diagnosis guidelines? A cross-sectional study from Kampala, Uganda Angella Atukunda Mwaka Amos Deogratius Emmanuel Arinaitwe Philip Orishaba Moses R. Kamya Joaniter I. Nankabirwa 2021-04-01T00:00:00Z https://doi.org/10.1186/s12936-021-03729-8 https://doaj.org/article/fbc6fa9b52ea44f3af74e65132cff1a6 EN eng BMC https://doi.org/10.1186/s12936-021-03729-8 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-03729-8 1475-2875 https://doaj.org/article/fbc6fa9b52ea44f3af74e65132cff1a6 Malaria Journal, Vol 20, Iss 1, Pp 1-8 (2021) Malaria diagnosis Declining transmission Clinician practices Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2021 ftdoajarticles https://doi.org/10.1186/s12936-021-03729-8 2022-12-31T15:48:43Z Abstract Background Uganda's clinical management guidelines recommend a malaria laboratory test in all patients presenting with fever (history of fever or an axillary temperature ≥ 37.5 °C), and only those with a positive test receive anti-malarial treatment. However, the current practice in areas with declining malaria transmission remains unknown. This study assessed the clinicians’ diagnostic practices, the factors associated with recommending a test, and the risk of missing a malaria case when a test is not recommended in patients presenting with fever in Kampala, an area of declining malaria transmission in Uganda. Methods Between January and March 2020, 383 participants aged ≥ 12 years and presenting to Kisenyi Health Centre IV in Kampala district with fever were enrolled in the study. A questionnaire was administered during exit interviews, routine diagnostic practices were recorded from participant clinical notes, and a research blood slide was obtained for later reading. Results Of the enrolled participants, 356 (93%) had a malaria diagnostic test recommended by the clinician. Factors associated with increasing prevalence of having a test recommended included; history of overnight travel (adjusted prevalence ratio [aPR] 1.07, 95% confidence interval [CI] 1.02–1.13, p = 0.011), being married (aPR = 1.07, 95% CI 1.01–1.13, p = 0.022), and having tertiary education (aPR = 1.09 95% CI 1.01–1.17, p = 0.031). Among the 27 participants where a malaria diagnostic test was not recommended, 4 (14.8%) had a positive study smear. Conclusion Despite having significant declines in malaria transmission in Kampala in the last decade, clinicians at the study health facility highly adhered to the clinical management guidelines, recommending a malaria test in almost all patients presenting with fever. However, a significant proportion of malaria cases was missed when a test was not recommended. These results highlight the importance of laboratory testing for malaria in all patients who present with fevers and live in ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 20 1 |
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English |
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Malaria diagnosis Declining transmission Clinician practices Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Malaria diagnosis Declining transmission Clinician practices Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Angella Atukunda Mwaka Amos Deogratius Emmanuel Arinaitwe Philip Orishaba Moses R. Kamya Joaniter I. Nankabirwa Do clinicians in areas of declining malaria transmission adhere to malaria diagnosis guidelines? A cross-sectional study from Kampala, Uganda |
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Malaria diagnosis Declining transmission Clinician practices Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Uganda's clinical management guidelines recommend a malaria laboratory test in all patients presenting with fever (history of fever or an axillary temperature ≥ 37.5 °C), and only those with a positive test receive anti-malarial treatment. However, the current practice in areas with declining malaria transmission remains unknown. This study assessed the clinicians’ diagnostic practices, the factors associated with recommending a test, and the risk of missing a malaria case when a test is not recommended in patients presenting with fever in Kampala, an area of declining malaria transmission in Uganda. Methods Between January and March 2020, 383 participants aged ≥ 12 years and presenting to Kisenyi Health Centre IV in Kampala district with fever were enrolled in the study. A questionnaire was administered during exit interviews, routine diagnostic practices were recorded from participant clinical notes, and a research blood slide was obtained for later reading. Results Of the enrolled participants, 356 (93%) had a malaria diagnostic test recommended by the clinician. Factors associated with increasing prevalence of having a test recommended included; history of overnight travel (adjusted prevalence ratio [aPR] 1.07, 95% confidence interval [CI] 1.02–1.13, p = 0.011), being married (aPR = 1.07, 95% CI 1.01–1.13, p = 0.022), and having tertiary education (aPR = 1.09 95% CI 1.01–1.17, p = 0.031). Among the 27 participants where a malaria diagnostic test was not recommended, 4 (14.8%) had a positive study smear. Conclusion Despite having significant declines in malaria transmission in Kampala in the last decade, clinicians at the study health facility highly adhered to the clinical management guidelines, recommending a malaria test in almost all patients presenting with fever. However, a significant proportion of malaria cases was missed when a test was not recommended. These results highlight the importance of laboratory testing for malaria in all patients who present with fevers and live in ... |
format |
Article in Journal/Newspaper |
author |
Angella Atukunda Mwaka Amos Deogratius Emmanuel Arinaitwe Philip Orishaba Moses R. Kamya Joaniter I. Nankabirwa |
author_facet |
Angella Atukunda Mwaka Amos Deogratius Emmanuel Arinaitwe Philip Orishaba Moses R. Kamya Joaniter I. Nankabirwa |
author_sort |
Angella Atukunda |
title |
Do clinicians in areas of declining malaria transmission adhere to malaria diagnosis guidelines? A cross-sectional study from Kampala, Uganda |
title_short |
Do clinicians in areas of declining malaria transmission adhere to malaria diagnosis guidelines? A cross-sectional study from Kampala, Uganda |
title_full |
Do clinicians in areas of declining malaria transmission adhere to malaria diagnosis guidelines? A cross-sectional study from Kampala, Uganda |
title_fullStr |
Do clinicians in areas of declining malaria transmission adhere to malaria diagnosis guidelines? A cross-sectional study from Kampala, Uganda |
title_full_unstemmed |
Do clinicians in areas of declining malaria transmission adhere to malaria diagnosis guidelines? A cross-sectional study from Kampala, Uganda |
title_sort |
do clinicians in areas of declining malaria transmission adhere to malaria diagnosis guidelines? a cross-sectional study from kampala, uganda |
publisher |
BMC |
publishDate |
2021 |
url |
https://doi.org/10.1186/s12936-021-03729-8 https://doaj.org/article/fbc6fa9b52ea44f3af74e65132cff1a6 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 20, Iss 1, Pp 1-8 (2021) |
op_relation |
https://doi.org/10.1186/s12936-021-03729-8 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-03729-8 1475-2875 https://doaj.org/article/fbc6fa9b52ea44f3af74e65132cff1a6 |
op_doi |
https://doi.org/10.1186/s12936-021-03729-8 |
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Malaria Journal |
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20 |
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1 |
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1766345638719520768 |