Assessment of malaria diagnostic services in Serenje District, Zambia

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Mufune, Tiza
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Zambia is one of the countries that have embarked on improved and accurate diagnosis of malaria in order to optimize the out come of malaria management. This has led to a change of policy, which emphasized the importance of accurate malaria diagnosis as one of the key interventions in malaria treatment and control. It is expected that this change in policy would lead to a more focused, efficient and cost effective malaria management programme, and overall improved malaria diagnosis and treatment. In this cross sectional, facility-based research study, aimed at assessing malaria diagnostic services in Serenje District, a semi structured questionnaire and facility check list were administered in 8 selected health facilities. A sample of 21 staff that routinely diagnosed and treated malaria for the period January to December 2011 was used and 320 case files were reviewed to collect data. Data derived from open ended questions and checklists was analysed by qualitative content analysis. Descriptive data was presented using graphs, charts and tables. Numerical data that was derived from the checklists and questionnaires was analysed using the Statistical Package for Social Sciences (SPSS) version seventeen.Prescription of antimalaria drugs was determined by the test result (X=78.53, p < 0.05 for patients under 5 years and X=80.42, p<0.05 for patients above 5 years). However, 30.1% (n=43) of the patients under 5 years and 13.6% (n=16) of patients above the age of 5 who received anti-malaria prescriptions were not tested for malaria at all. Comparison of RDTs done with reported malaria cases shows a disproportionately high number of RDTs performed at 142.5% and 136.9% of total malaria cases diagnosed in patients under 5 and above 5 years respectively. Generally, the district had adequate malaria diagnostic commodities in the health facilities, most of which are malaria RDTs. Health care workers adhered to malaria guidelines by prescribing anti-malaria drugs to patients with positive RDT and rarely, in the case of a negative result. However, about a third of all children treated for malaria were treated based on clinical signs and symptoms. There was inadequate clinical assessment of patients, leading to unguided use of RDTs, consequently resulting in overuse of malaria diagnostic commodities. A study to establish factors associated with overuse of malaria diagnostic commodities in health facilities should be conducted.
Malaria , Malaria Test