S V Dlamini1, R J Kosgei2, N Mkhonta3, Z Zulu3, K Makadzange4, S Zhou5, P Owiti6, W Sikhondze7, J Namboze8, A Reid9, S Kunene3. 1. Faculty of Health Sciences, University of Swaziland, Mbabane, Swaziland. 2. Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya. 3. National Malaria Control Programme, Ministry of Health, Mbabane, Swaziland. 4. World Health Organization (WHO), Swaziland Country Office, Mbabane, Swaziland. 5. National Institute for Parasitic Diseases, Chinese Centre for Disease Control and Prevention, Beijing, China. 6. Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya. 7. National Tuberculosis Control Programme, Ministry of Health, Mbabane, Swaziland. 8. WHO, African Regional Office and Inter-Country Support Team, Asmara, Eritrea. 9. Operational Research Unit, Operational Centre Brussels, Médecins Sans Frontières, Luxembourg City, Luxembourg.
Abstract
Objective: To assess adherence to malaria diagnosis and treatment guidelines (2010 and 2014) in all health care facilities in Swaziland between 2011 and 2015. Methods: This was a cross-sectional descriptive study involving all health care facilities that diagnosed and managed malaria cases in Swaziland. Patients' age, sex, diagnosis method and type of treatment were analysed. Results: Of 1981 records for severe and uncomplicated malaria analysed, 56% of cases were uncomplicated and 14% had severe malaria. The type of malaria was not recorded for 30% of cases. Approximately 71% of cases were confirmed by rapid diagnostic tests (RDT) alone, 3% by microscopy alone and 26% by both RDT and microscopy. Of the uncomplicated cases, 93% were treated with artemether-lumefantrine (AL) alone, 5% with quinine alone and 2% with AL and quinine. Amongst the severe cases, 11% were treated with AL alone, 44% with quinine alone and 45% with AL and quinine. For severe malaria, clinics and health centres prescribed AL alone more often than hospitals (respectively 13%, 12% and 4%, P = 0.03). Conclusion: RDTs and/or microscopy results are used at all facilities to inform treatment. Poor recording of malaria type causes difficulties in assessing the prescription of antimalarial drugs.
Objective: To assess adherence to malaria diagnosis and treatment guidelines (2010 and 2014) in all health care facilities in Swaziland between 2011 and 2015. Methods: This was a cross-sectional descriptive study involving all health care facilities that diagnosed and managed malaria cases in Swaziland. Patients' age, sex, diagnosis method and type of treatment were analysed. Results: Of 1981 records for severe and uncomplicated malaria analysed, 56% of cases were uncomplicated and 14% had severe malaria. The type of malaria was not recorded for 30% of cases. Approximately 71% of cases were confirmed by rapid diagnostic tests (RDT) alone, 3% by microscopy alone and 26% by both RDT and microscopy. Of the uncomplicated cases, 93% were treated with artemether-lumefantrine (AL) alone, 5% with quinine alone and 2% with AL and quinine. Amongst the severe cases, 11% were treated with AL alone, 44% with quinine alone and 45% with AL and quinine. For severe malaria, clinics and health centres prescribed AL alone more often than hospitals (respectively 13%, 12% and 4%, P = 0.03). Conclusion: RDTs and/or microscopy results are used at all facilities to inform treatment. Poor recording of malaria type causes difficulties in assessing the prescription of antimalarial drugs.
Entities:
Keywords:
SORT IT; Swaziland; malaria case management; malaria elimination
Authors: Bruno Moonen; Justin M Cohen; Robert W Snow; Laurence Slutsker; Chris Drakeley; David L Smith; Rabindra R Abeyasinghe; Mario Henry Rodriguez; Rajendra Maharaj; Marcel Tanner; Geoffrey Targett Journal: Lancet Date: 2010-10-28 Impact factor: 79.321
Authors: Laura R Sangaré; Noel S Weiss; Paula E Brentlinger; Barbra A Richardson; Sarah G Staedke; Mpungu S Kiwuwa; Andy Stergachis Journal: Malar J Date: 2011-06-06 Impact factor: 2.979
Authors: Andrew Nyandigisi; Dorothy Memusi; Agneta Mbithi; Newton Ang'wa; Mildred Shieshia; Alex Muturi; Raymond Sudoi; Sophie Githinji; Elizabeth Juma; Dejan Zurovac Journal: PLoS One Date: 2011-09-14 Impact factor: 3.240
Authors: Christina Riley; Stephanie Dellicour; Peter Ouma; Urbanus Kioko; Feiko O ter Kuile; Ahmeddin Omar; Simon Kariuki; Ann M Buff; Meghna Desai; Julie Gutman Journal: PLoS One Date: 2016-01-20 Impact factor: 3.240
Authors: Ric N Price; Grant Dorsey; Elizabeth A Ashley; Karen I Barnes; J Kevin Baird; Umberto d'Alessandro; Philippe J Guerin; Miriam K Laufer; Inbarani Naidoo; François Nosten; Piero Olliaro; Christopher V Plowe; Pascal Ringwald; Carol H Sibley; Kasia Stepniewska; Nicholas J White Journal: Malar J Date: 2007-09-06 Impact factor: 2.979
Authors: H Hilda Ampadu; Kwaku Poku Asante; Samuel Bosomprah; Samantha Akakpo; Pierre Hugo; Helga Gardarsdottir; Hubert G M Leufkens; Dan Kajungu; Alexander N O Dodoo Journal: Malar J Date: 2019-02-08 Impact factor: 2.979