Knowledge, attitude, and practice of the National Guidelines for Diagnosis and Treatment of Malaria among medical doctors in Ebonyi state, Nigeria: A cross-sectional survey

Abstract

Background The Guidelines for Diagnosis and Treatment of Malaria are meant to guide medical practitioners to enhance optimal management of patients suspected of having malaria which is vital to malarial control and elimination. Medical doctors have the main responsibility for treating patients with malaria so there was need to evaluate the extent to which the medical doctors in Ebonyi state, Nigeria, knew, viewed, and practiced the 2015 National Guidelines for Diagnosis and Treatment of Malaria. Methods A cross-sectional survey was carried out in May, 2019 among medical doctors who were involved in the management of malaria patients and selected via convenience sampling. Data was collected using a structured self-administered questionnaire. Each respondent was categorized as having poor, fair, or good knowledge, attitude, and practice respectively based on knowledge, attitude, and practice scores of <50%, 50–75%, and >75%. Associated factors were evaluated through bivariate and multivariate binomial logistic regressions at 5% probability of type one error and the overall test for the effect of each independent factor on practice level was done using the “postestimation test” command in Stata. Results A total of 156 medical doctors were surveyed. Most, 138 (88.5%) were aware there was a national guideline for diagnosis and treatment of malaria. Among the medical doctors, 19 (12.2%) had good knowledge, 110 (70.5%) had fair knowledge, and 27 (17.3%) had poor knowledge; 38 (24.4%) had good attitude, 74 (47.4%) had fair attitude, and 44 (28.2%) had poor attitude; and 59 (37.8%) had good practice, 90 (57.7%) had fair practice, and 7 (4.5%) had poor practice. The attitude level of the medical doctors toward the 2015 National Guidelines for Diagnosis and Treatment of Malaria was a predictor of good practice (adjusted p-value of overall effect = 0.0003). Conclusions Although most of the medical doctors in Ebonyi state, Nigeria, were aware of the existence of a national guideline, only just over a third of them had good practice of the 2015 National Guidelines for Diagnosis and Treatment of Malaria. Policy interventions should focus on improving the attitude of the medical doctors toward the National Guidelines through training and re-training.

Knowledge, attitudes, and practices (KAP) during the malaria elimination phase: A household-based cross-sectional survey

“…However, there was misconception with regard to the vector that transmitted malaria as only 1 to 3rd of the respondents selected mosquitoes as a pathogen vector for malaria. The findings of this study lend credence to those found in earlier research carried out in Nigeria, [23,34,35] Guinea, [28] Tanzania, [29] Ethiopia, [36] and India. [24]…”

“…The structured questionnaire included demographic characteristics in the first part (nationality, gender, social status, number of family members, income, education level, type of accommodation, and area). The second part contained questions about knowledge, attitudes, and practices, which were designed based on previous studies [4,[22][23][24][25][26][27][28][29][30] and World Health Organization guidelines. [2,11,15] The knowledge questions were about the causes of malaria, the primary vector, symptoms, preventive measures, personal means for prevention, and knowledge about mosquito behavior.…”

Knowledge about Asymptomatic Malaria and Acceptability of Using Artemisia afra Tea among Health Care Workers (HCWs) in Yaoundé, Cameroon: A Cross-Sectional Survey

“…The finding that duration of practice was significantly associated with respondents' knowledge about asymptomatic malaria transmission, and HCWs with 0-5 years of practice were less likely to be informed about asymptomatic malaria transmission compared to those with more years of practice, is expected, as HCWs may naturally gain more awareness, experience, and learn more about the condition with an increased number of years of practice. However, these findings were different from the results in Ebonyi State, Nigeria, where the number of years of practice was not significantly associated with doctors' knowledge of the national guidelines of malaria diagnosis and treatment [67]. The results showed that the proportion of correct respondents in rural hospitals was higher than that in the urban hospitals in all the assessment areas, which might be because most of the respondents in the rural hospitals were physicians (46%) (with only 18% being nursing assistants), while most of the respondents in the urban hospital were nursing assistants (34%).…”

Use of malaria rapid diagnostic test and anti-malarial drug prescription practices among primary healthcare workers in Ebonyi state, Nigeria: An analytical cross-sectional study

“…Compared with the 68.0% in this study, a much lower proportion of 27.5% of the medical doctors in Ebonyi state were reported to never or rarely prescribed anti-malarial drugs for patients with negative MRDT results [ 45 ]. This much lower value could be due to the fact that the medical doctors (across tertiary and secondary health facilities), in most cases, believed in using their clinical judgement and discretion with less compliance to the recommendation that anti-malarial drugs should be prescribed for only patients with positive MRDT (or microscopy) results.…”