Joseph Keating1, Timothy P Finn2, Thomas P Eisele3, Gilbert Dery4, Ekow Biney5, Marius Kêdoté6, Benjamin Fayomi6, Joshua O Yukich3. 1. Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans LA 70112, USA jkeating@tulane.edu. 2. Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans LA, USA. 3. Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans LA 70112, USA. 4. DERMED Consult LLC, Tamale, Ghana. 5. Clinical Laboratory Unit, Institutional Care Division, Ghana Health Service, Korle-Bu, Accra, Ghana. 6. Institut des Sciences Biomédicales Appliquées (ISBA), Cotonou, Benin.
Abstract
BACKGROUND: In malaria-endemic countries, the absence of parasitological confirmation of malaria infection potentially results in overtreatment of non-malaria febrile illness with antimalarial drugs; this may lead to healthcare workers (HCW) missing other treatable illness or wastage of resources. This paper presents results from nationally representative assessments of malaria diagnostic accuracy, quality and capacity in Ghana and the Republic of Benin. METHODS: Cross-sectional surveys were conducted in December 2012 among a representative sample of health facilities (n=30 per country), using a modified service provision assessment, followed by HCW observations and interviews. To analyze the data we used χ(2) statistics and logistic regression. RESULTS: Malaria microscopy and rapid diagnostic test interpretation was accurate most of the time in both countries. Drugs were generally prescribed in line with positive malaria test results (Ghana: 85.4%, 95% CI: 72.2-98.7; Benin: 83.6%, 95% CI: 68.7-98.4), although some patients with negative malaria test results still received treatment (Ghana: 30.1%, 95% CI: 11.1-49.0; Benin: 37.8%, 95% CI: 22.6-53.0). CONCLUSIONS: Diagnostics for malaria are often performed adequately and accurately in Ghana and Benin, although diagnostic coverage within facilities remains incomplete and some individuals who test negative for malaria receive antimalarial drugs.
BACKGROUND: In malaria-endemic countries, the absence of parasitological confirmation of malaria infection potentially results in overtreatment of non-malaria febrile illness with antimalarial drugs; this may lead to healthcare workers (HCW) missing other treatable illness or wastage of resources. This paper presents results from nationally representative assessments of malaria diagnostic accuracy, quality and capacity in Ghana and the Republic of Benin. METHODS: Cross-sectional surveys were conducted in December 2012 among a representative sample of health facilities (n=30 per country), using a modified service provision assessment, followed by HCW observations and interviews. To analyze the data we used χ(2) statistics and logistic regression. RESULTS:Malaria microscopy and rapid diagnostic test interpretation was accurate most of the time in both countries. Drugs were generally prescribed in line with positive malaria test results (Ghana: 85.4%, 95% CI: 72.2-98.7; Benin: 83.6%, 95% CI: 68.7-98.4), although some patients with negative malaria test results still received treatment (Ghana: 30.1%, 95% CI: 11.1-49.0; Benin: 37.8%, 95% CI: 22.6-53.0). CONCLUSIONS: Diagnostics for malaria are often performed adequately and accurately in Ghana and Benin, although diagnostic coverage within facilities remains incomplete and some individuals who test negative for malaria receive antimalarial drugs.
Authors: Lawrence G Febir; Frank E Baiden; Justina Agula; Rupert K Delimini; Bright Akpalu; Mathilda Tivura; Nelson Amanfo; Daniel Chandramohan; Seth Owusu-Agyei; Jayne Webster Journal: Malar J Date: 2015-04-23 Impact factor: 2.979
Authors: Emily White Johansson; Peter W Gething; Helena Hildenwall; Bonnie Mappin; Max Petzold; Stefan Swartling Peterson; Katarina Ekholm Selling Journal: Malar J Date: 2015-05-10 Impact factor: 2.979