Health workers’ perception of malaria rapid diagnostic test and factors influencing compliance with test results in Ebonyi state, Nigeria

English version

Autoři: Izuchukwu Frank Obi ^aff001; Kabiru Sabitu ^aff002; Abdulhakeem Olorukooba ^aff002; Ayo Stephen Adebowale ^aff004; Rabi Usman ^aff001; Ugochukwu Nwokoro ^aff001; Olufemi Ajumobi ^aff005; Suleiman Idris ^aff002; Lawrence Nwankwo ^aff007; IkeOluwapo O. Ajayi ^aff001
Působiště autorů: Nigeria Field Epidemiology and Laboratory Training Program, Abuja, FCT, Nigeria ^aff001; Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria ^aff002; Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria ^aff003; Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria ^aff004; Malaria Consortium, Abuja, Nigeria ^aff005; National Malaria Elimination Program, Federal Ministry of Health, Abuja, Nigeria ^aff006; Malaria Elimination Program, Ministry of Health, Abakaliki, Ebonyi State, Nigeria ^aff007
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0223869

Souhrn

Background

The standard practice in treating uncomplicated malaria is to prescribe artemisinin-based combination therapy (ACT) for only patients with positive test results. However, health workers (HWs) sometimes prescribe ACTs for patients with negative malaria rapid diagnostic test (mRDT) results. Available evidence on HWs perception of mRDT and their level of compliance with test results in Nigeria lacks adequate stratification by state and context. We assessed HWs perception of mRDT and factors influencing ACTs prescription to patients with negative mRDT results in Ebonyi state, Nigeria.

Methods

A cross-sectional survey was conducted among 303 HWs who treat suspected malaria patients in 40 randomly selected public and private health facilities in Ebonyi state. Health workers’ perception of mRDT was assessed with 18 equally weighted five-point likert scale questions with maximum obtainable total score of 90. Scores ≥72 were graded as good and less, as poor perception. Data were analysed using descriptive statistics and logistic regression model at 5% significance level.

Results

Mean age of respondents was 34.6±9.4 years, 229 (75.6%) were females, 180 (59.4%) community health workers and 67 (22.1%) medical doctors. Overall, 114 (37.6%) respondents across healthcare facility strata had poor perception of mRDT. Respondents who prescribed ACTs to patients with negative mRDT results within six months preceding the survey were 154 (50.8%) [PHCs: 50 (42.4%), General hospitals: 18 (47.4%), tertiary facility: 51 (79.7%) and missionary hospitals: 35 (42.2%)]. Poor HWs’ perception of mRDT promoted prescription of ACT to patients with negative mRDT results (AOR = 5.6, 95% C.I = 3.2–9.9). The likelihood of prescribing ACTs to patients with negative mRDT results was higher among HWs in public health facilities (AOR = 2.8, 95% C.I = 1.4–5.5) than those in the private.

Conclusions

The poor perception of mRDT and especially common prescribing of ACTs to patients with negative mRDT results among HWs in Ebonyi state calls for context specific interventions to improve their perception and compliance with mRDT test results.

Klíčová slova:

Health care facilities – Medical doctors – Diagnostic medicine – Malaria – Social systems – Nigeria – Malarial parasites – Antimalarials

Zdroje

1. World Health Organization. World Malaria Report 2018. Geneva; 2018.

2. World Health Organization. High Burden to High Impact: A targeted malaria response [Internet]. 2019. Available from: https://www.who.int/malaria/publications/atoz/high-impact-response/en/

3. Grobusch MP, Kremsner PG. Uncomplicated malaria. Curr Top Microbiol Immunol [Internet]. 2005 [cited 2016 Dec 7];295:83–104. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16265888 16265888

4. World Health Organization. Parasitological confirmation of malaria diagnosis [Internet]. October. Geneva; 2009. Available from: http://whqlibdoc.who.int/publications/2010/9789241599412_eng.pdf

5. World Health Organization. Global Technical Strategy for Malaria 2016–2030. WHO Geneva [Internet]. 2015;1–35. Available from: http://apps.who.int/iris/bitstream/10665/176712/1/9789241564991_eng.pdf?ua=1

6. World Health Organization. Guidelines for the treatment of Malaria. third edit. WHO Press, Geneva; 2015.

7. NMCP FMOH. National Guidelines for Diagnosis and Treatment of Malaria. Abuja; 2011.

8. World Health Organization, Foundation for Innovative New Diagnostics, TDR, Roll Back Malaria. Malaria Rapid Diagnostic Tests. 2012; Available from: http://www2.wpro.who.int/sites/rdt/home.htm

9. Lal S, Ndyomugenyi R, Paintain L, Alexander ND, Hansen KS, Magnussen P, et al. Community health workers adherence to referral guidelines: evidence from studies introducing RDTs in two malaria transmission settings in Uganda. Malar J. BioMed Central; 2016;1–13. doi: 10.1186/s12936-015-1044-1

10. Kyabayinze DJ, Asiimwe C, Nakanjako D, Nabakooza J, Counihan H, Tibenderana JK. Use of RDTs to improve malaria diagnosis and fever case management at primary health care facilities in Uganda. Malar J [Internet]. 2010 [cited 2017 Mar 5];9:200. Available from: http://malariajournal.biomedcentral.com/articles/10.1186/1475-2875-9-200 20624312

11. Chandler CIR, Whitty CJM, Ansah EK. How can malaria rapid diagnostic tests achieve their potential? A qualitative study of a trial at health facilities in Ghana. Malar J [Internet]. 2010;9:95. Available from: doi: 10.1186/1475-2875-9-95 20398262

12. Ajumobi O, Sabitu K, Nguku P, Kwaga J, Ntadom G, Gitta S, et al. Performance of an HRP-2 Rapid Diagnostic Test in Nigerian Children Less Than 5 Years of Age. Am J Trop Med Hyg [Internet]. 2015;92:828–33. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385782/ doi: 10.4269/ajtmh.13-0558 25711608

13. Alexandre Macedo de Oliveira, Jacek Skarbinski, Peter O. Simon Ouma Kariuki, John W. Barnwell, Kephas Otieno, Phillip Onyona, Louise M. Causer, Kayla F. Laserson, Willis S. Akhwale LS and MH. Performance of Malaria Rapid Diagnostic Tests as Part of Routine Malaria Case Management in Kenya. Am J Trop Med Hyg. 2009;80:470–4. 19270300

14. Azikiwe CCA, Ifezulike CC, Siminialayib IM, Amazuc LU, Enye JC NO. A comparative laboratory diagnosis of malaria_ microscopy versus rapid diagnostic test kits. Asian Pac J Trop Biomed. 2012;2:307–10. doi: 10.1016/S2221-1691(12)60029-X 23569920

15. Minja DTR, Schmiegelow C, Oesterholt M, Magistrado PA, Boström S, John D, et al. Reliability of rapid diagnostic tests in diagnosing pregnancy-associated malaria in north-eastern Tanzania. Malar. J. 2012. p. 211. doi: 10.1186/1475-2875-11-211 22720788

16. World Health Organization. WHO releases new malaria guidelines for treatment and procurement of medicines [Internet]. Media Cent. News releases. 2010 [cited 2016 Jun 23]. Available from: www.who.int/mediacentre/news/releases/2010/malaria_20100308/en/

17. Kabaghe AN, Visser BJ, Spijker R, Phiri KS, Grobusch MP, van Vugt M. Health workers’ compliance to rapid diagnostic tests (RDTs) to guide malaria treatment: a systematic review and meta-analysis. Malar J. BioMed Central; 2016;15:163.

18. Mubi M, Kakoko D, Ngasala B, Premji Z, Peterson S, Björkman A, et al. Malaria diagnosis and treatment practices following introduction of rapid diagnostic tests in Kibaha District, Coast Region, Tanzania. Malar J. BioMed Central; 2013;12:293.

19. Mokuolu OA, Ntadom GN, Ajumobi OO, Alero RA, Wammanda RD, Adedoyin OT, et al. Status of the use and compliance with malaria rapid diagnostic tests in formal private health facilities in Nigeria. Malar J [Internet]. BioMed Central; 2016 [cited 2016 Aug 21];15:4. Available from: http://www.malariajournal.com/content/15/1/4 26728037

20. Akinyode A, Ajayi I, Ibrahim M, Akinyemi J, Ajumobi O. Practice of antimalarial prescription to patients with negative rapid test results and associated factors among health workers in Oyo State, Nigeria. 2018;8688:1–8.

21. Uzochukwu B, Chiegboka L, Enwereuzo C, Nwosu U, Okorafor D, Onwujekwe O, et al. Examining appropriate diagnosis and treatment of malaria: availability and use of rapid diagnostic tests and artemisinin-based combination therapy in public and private health facilities in south east Nigeria. BMC Public Health. 2010;10:486. doi: 10.1186/1471-2458-10-486 20712876

22. Ansah EK, Reynolds J, Akanpigbiam S, Whitty CJ, Chandler CI, Hamer D, et al. “Even if the test result is negative, they should be able to tell us what is wrong with us”: a qualitative study of patient expectations of rapid diagnostic tests for malaria. Malar J [Internet]. BioMed Central; 2013 [cited 2016 Dec 19];12:258. Available from: http://malariajournal.biomedcentral.com/articles/10.1186/1475-2875-12-258 23876112

23. Altaras R, Nuwa A, Agaba B, Streat E, Tibenderana JK, Strachan CE. Why do health workers give anti-malarials to patients with negative rapid test results? A qualitative study at rural health facilities in western Uganda. Malar J [Internet]. BioMed Central; 2016 [cited 2016 Dec 20];15:23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26754484 doi: 10.1186/s12936-015-1020-9 26754484

24. Welle SC, Ajumobi O, Dairo M, Balogun M, Adewuyi P, Adedokun B, et al. Preference for Artemisinin–based combination therapy among healthcare providers, Lokoja, North-Central Nigeria. Glob Heal Res Policy [Internet]. BioMed Central; 2019 [cited 2019 May 30];4:1. Available from: https://ghrp.biomedcentral.com/articles/10.1186/s41256-018-0092-9

25. Bamiselu OF, Ajayi I, Fawole O, Dairo D, Ajumobi O, Oladimeji A, et al. Adherence to malaria diagnosis and treatment guidelines among healthcare workers in Ogun State, Nigeria. BMC Public Health. 2016;16. doi: 10.1186/s12889-015-2687-0

26. Usman R, Umar AA, Saheed GS, Gobir AA, Obi IF, Ajayi I, et al. Predictors of malaria Rapid Diagnostic Tests ‘ utilisation among healthcare workers in Zamfara State. 2018;198:1–10. Available from: https://doi.org/10.1371/journal. pone.0200856

27. National Malaria Elimination Programme (NMEP), National Population Commission (NPopC), National Bureau of Statistics (NBS) and II. Nigeria Malaria Indicator Survey 2015. Abuja, Nigeria and Rockville, Maryland, USA; 2016.

28. Odoh B. Ebonyi State Factsheet. Abakaliki; 2015.

29. Mokuolu OA, Ajumobi OO, Ntadom GN, Adedoyin OT, Roberts AA, Agomo CO, et al. Provider and patient perceptions of malaria rapid diagnostic test use in Nigeria: a cross ‑ sectional evaluation. Malar J [Internet]. BioMed Central; 2018;1–9. Available from: doi: 10.1186/s12936-017-2149-5

30. Kok MC, Kane SS, Tulloch O, Ormel H, Theobald S, Dieleman M, et al. How does context influence performance of community health workers in low- and middle-income countries? Evidence from the literature. 2015;

31. Andrada A, Herrera S, Inyang U, Mohammed AB, Uhomoibhi P. A subnational profiling analysis reveals regional differences as the main predictor of ITN ownership and use in Nigeria. Malar J [Internet]. BioMed Central; 2019;1–16. Available from: doi: 10.1186/s12936-018-2635-4

32. Ebonyi State MOH. 2016 Annual Operational Plan for Ebonyi State Malaria Elimination Program. Abakaliki; 2016.

33. Ebonyi State Government. Ebonyi State Government Strategic Health Development Plan 2010–2015. 2010. 2010.

34. Israel GD. Determining Sample Size. Univ Florida Coop Ext Serv Instititute Food Agric Sci. 2013;1–5.

35. Kirkwood B, Sterne J. Calculation of required sampling size. Essent Med Stat. 2003. p. 413–28.

36. World Health Organisation. World Health Organization Vaccination Coverage Cluster Surveys: Reference Manual. 2015;Version 3:B1–25.

37. Uzochukwu BSC, Onwujekwe E, Ezuma NN, Ezeoke OP, Ajuba MO, Sibeudu FT. Improving rational treatment of malaria: Perceptions and influence of RDTs on prescribing behaviour of health workers in Southeast Nigeria. PLoS One. 2011;6:1–7.