Management of uncomplicated malaria in private health facilities in North-West Ethiopia: a clinical audit of current practices

Abstract

BackgroundMalaria is one of the leading public health problems in sub-Saharan Africa that contributes to significant patient morbidity and mortality. The aim of the study was to investigate adherence to malaria diagnosis and treatment guidelines by private health sector providers and compare their performance against the public private partnership (PPP) status.MethodsA facility-based retrospective clinical audit was conducted between October 2016 and January 2017 in 11 medium clinics in the West Gojjam zone of the Amhara Region, North-west Ethiopia. Data was extracted from patient medical records using pretested data abstraction forms. Descriptive statistics were employed to present the findings and adherence of health workers against the national and international standards were classified as ideal, acceptable, minor error and major error for both malaria diagnosis and treatment. A chi-square (X2) test was used to test for a statistically significant relationship after the data had been categorized using public private partnership status at P < 0.05.ResultsOne thousand six hundred fifty clinical files were audited. All malaria suspected patients were investigated either with microscopy or rapid diagnostics test (RDT) for parasitological confirmation. The proportion of malaria treated cases was 23.7% (391/1650). Of which 16.6% (274/1650) were uncomplicated, 3.69% (61 /1650) were severe and complicated and the rest 3.39% (56/1650) were clinical diagnosed malaria cases. And the malaria parasite positivity rate was 20.30% (335/1650). All malaria suspected patients were not investigated with ideal malaria diagnosis recommendations; only 19.4% (320/1650) were investigated with acceptable malaria diagnosis (public private partnership (PPP) 19.4%; 176/907; and non-public private partnership (NPPP) 19.38%; 144/743, X2 (1) = 0.0With regards to treatments of malaria cases, the majority 82.9% of Plasmodium vivax cases were managed with ideal recommended treatment (X2 (1) = 0.35, P = 0.55); among Plasmodium falciparum, mixed (Plasmodium falciparum and Plasmodium vivax).ConclusionThe clinical audit revealed that the majority of malaria patients had received minor error malaria diagnostic services. In addition, only one fifth of malaria patients had received ideal malaria treatment services. To understand the reasons for the low levels of malaria diagnosis and treatment adherence with national guidelines, a qualitative exploratory descriptive study is recommended.

Phenotypic characterization of acute headache attributed to SARS-CoV-2: An ICHD-3 validation study on 106 hospitalized patients

“…Headache is a common symptom in patients with viral infection, described in 47–55% of patients with influenza (22), 17% of patients with Epstein-Barr virus infectious mononucleosis, and 48% of patients with cytomegalo virus infectious mononucleosis (23). Headache is also frequently reported in other diseases such as malaria (50–75%) (24,25) and dengue (59.4%) (26). The pathophysiology of the headache in systemic infections might be linked to cytokine release (27), the presence of fever (1), systemic inflammation (1,2), or the direct damage caused by the pathogens (2), among other factors.…”

Knowledge and practices regarding malaria and the National Treatment Guidelines among public health workers in Equatorial Guinea

“…The index of knowledge regarding malaria and the recommendations included in the NMTG of Equatorial Guinea is low amongst most health practitioners in the Bata District, being higher among hospital practitioners, who have fewer years of experience than the practitioners at the health centres, but who possess a higher degree of academic education. Low knowledge regarding malaria protocols is frequent in many African countries [ 32 , 33 ], both in the private and public sector [ 8 , 19 , 34 . 35 ].…”

Community and Health Care Providers Perception on Quality of Private Sector Outpatient Malaria Care in North West Ethiopia: A Qualitative Study

“…Design of the study In this cross-sectional an exploratory, descriptive, contextual, qualitative study with thematic analysis was employed to deeper understanding of bene ciaries and healthcare providers perceived quality of outpatient malaria care services in private health facilities [15]…”

“…Therefore, engagement of healthcare providers, and patients or care takers improves access to and demand for affordable standardized public health services. However, the perception of both healthcare providers and adult outpatient bene ciaries towards quality of malaria service had never been explored and described in Ethiopia [15]. Hence this qualitative exploratory descriptive study was conducted by the researchers.…”