The quality of malaria case management in different transmission settings in Tanzania mainland, 2017-2018.

Autor:	Hussein AK; Tanzania Field Epidemiology and Laboratory Training Program, Dar es Salaam, United Republic of Tanzania.; Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania., Tarimo D; Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania., Reaves EJ; U.S. President's Malaria Initiative, U.S. Centers for Disease Control and Prevention, Dar es Salaam, United Republic of Tanzania., Chacky F; National Malaria Control Program, Dodoma, United Republic of Tanzania.; Ministry of Health, Dodoma, United Republic of Tanzania., Abade AM; Tanzania Field Epidemiology and Laboratory Training Program, Dar es Salaam, United Republic of Tanzania., Mwalimu CD; Ministry of Health, Dodoma, United Republic of Tanzania., Mohamed A; National Malaria Control Program, Dodoma, United Republic of Tanzania.; Ministry of Health, Dodoma, United Republic of Tanzania., Nasser A; Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania., Kishimba RS; Tanzania Field Epidemiology and Laboratory Training Program, Dar es Salaam, United Republic of Tanzania.; Ministry of Health, Dodoma, United Republic of Tanzania.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2023 Aug 21; Vol. 3 (8), pp. e0002318. Date of Electronic Publication: 2023 Aug 21 (Print Publication: 2023).
DOI:	10.1371/journal.pgph.0002318
Abstrakt:	Tanzania is undergoing an epidemiological transition for malaria transmission with some areas of the country having <10% (hypoendemic) and other areas 10% - 50% malaria prevalence (mesoendemic). It is not known whether there is a difference in the quality of malaria case management based on endemicity in Tanzania mainland. We examined the influence of endemicity on the quality of malaria case management at health facilities. We conducted a cross-sectional analysis of 1713 health facilities in Tanzania mainland, using data collected by the National Malaria Control Program through an assessment tool to evaluate quality of malaria case management. The data was gathered from September 2017 to December 2018. Using standard quality factors, mean scores from facilities in the different endemicity regions were compared by a Student's t-test. Simple and multiple linear regression analyses were performed to determine the association between facility performance (score) and endemicity (mesoendemic vs. hypoendemic). Facilities in mesoendemic regions scored higher than those in hypoendemic regions on the overall quality of services [difference in mean scores ([Formula: see text]) = 2.52; (95% Confidence Interval (CI) 1.12, 3.91)], site readiness [[Formula: see text] = 2.97; (95% CI 1.30, 4.61)], availability of malaria reference materials [[Formula: see text] = 4.91; (95% CI 2.05, 7.76)], availability of Health Management Information System tools [[Formula: see text] = 5.86; (95% CI 3.80, 7.92)] and patient satisfaction [[Formula: see text] = 6.61; (95% CI 3.75, 9.48)]. Predictors associated with lower facility scores included; being located in a hypoendemic region [β: -2.49; (95% CI -3.83, -1.15)] and urban area [β: -3.84; (95% CI -5.60, -2.08)]. These findings highlight the differences in quality of malaria case management based on endemicity, but there is still a need to target improvement efforts in underperforming facilities, regardless of endemicity. Competing Interests: The authors have declared that no competing interests exist. (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu