Compliance With Malaria Rapid Diagnostic Testing by Community Health Workers in 3 Malaria-Endemic Countries of Sub-Saharan Africa: An Observational Study
| Autor: | Joëlle Castellani, Max Petzold, Luc Sermé, Jan Singlovic, Armande K. Sanou, IkeOluwapo O. Ajayi, Chinenye Afonne, Melba Gomes, Zakaria Gansane, Catherine O. Falade, Ayodele Samuel Jegede, Vanessa Kabarungi, Jesca Nsungwa-Sabiiti, Josephine Kyaligonza, Mohamadou Siribié |
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| Předmět: |
Microbiology (medical)
Male Sub saharan 030231 tropical medicine malaria Artesunate compliance to test result rapid diagnostic test 03 medical and health sciences community health worker Antimalarials 0302 clinical medicine Administration Rectal Environmental health parasitic diseases Medicine Community health workers Humans 030212 general & internal medicine health care economics and organizations Community Health Workers Rapid diagnostic test business.industry Diagnostic Tests Routine Odds ratio medicine.disease ACT Confidence interval Artemisinins Clinical trial Infectious Diseases Optometry Patient Compliance Observational study Malaria in Highly Endemic Areas: Improving Control through Diagnosis Artemisinin Combination Therapy and Rectal Artesunate Treatment Female business Malaria |
| Zdroj: | Scopus-Elsevier Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| Popis: | Background The World Health Organization recommends that all malaria management be based on parasitological identification. We monitored performance of trained community health workers (CHWs) in adhering to this recommendation to restrict artemisinin-based combination therapies (ACTs) to positive rapid diagnostic test (RDT)-confirmed cases in children in 3 malaria-endemic sub-Saharan African countries. Methods In 33 villages in Burkina Faso, 45 villages in Nigeria, and 84 villages in Uganda, 265 CHWs were trained over a minimum of 3 days to diagnose malaria using RDTs (prepare, read, record results, and inform the patient about results) and treat RDT-confirmed uncomplicated malaria cases with ACTs. In Nigeria, CHWs were also taught to obtain a thick blood smear. Spent RDT kits and prepared blood slides were collected and interpreted independently in Burkina Faso and Nigeria to confirm CHWs' diagnoses. Interviews were held with 12 of 17 CHWs who prescribed ACTs for patients with RDT-negative test results, and with 16 of 29 caregivers to determine factors related to noncompliance. Results Of 12 656 patients treated with ACTs in the participating countries (5365 in Burkina Faso, 1648 in Nigeria, and 5643 in Uganda), 29 patients (8 from Burkina Faso, 17 from Nigeria, 4 from Uganda) were RDT negative. The small number of RDT-negative ACT-treated cases limits statistical analysis. Only a few CHWs were involved, and they were more likely to be traders rather than farmers (odds ratio [OR], 6.15; 95% confidence interval [CI], 2.09-18.07; P = .0004). RDT-negative children who were treated with ACTs had a significantly higher probability of residing in a village other than that of the CHW (OR, 3.85; 95% CI, 1.59-9.30; P = .0018). Parental pressure was identified in interviews with parents. Conclusions Noncompliance with results of RDT tests is relatively rare when CHWs are trained and well supervised. Clinical trials registration ISRCTN13858170. |
| Databáze: | OpenAIRE |
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