Utilization of Malaria Diagnostic Tests and Receipt of Anti-Malarial Drugs by Febrile Patients Attending Outpatient Clinics of Health Centre IV Facilities in Mukono District, Uganda
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Date
2014
Journal Title
Journal ISSN
Volume Title
Publisher
Health
Abstract
Background: Failure to demonstrate the presence of malaria parasites prior to treatment with
anti-malarial drugs remains a challenge in Uganda, often resulting into over-prescription of antimalarial
drugs to febrile patients suspected of malaria. The aim of this study was to describe the
role of utilization of malaria diagnostic tests and associated factors in the receipt of anti-malarial
drugs among febrile patients suspected of malaria. Methods: In a cross-sectional study design, client-
exit interviews with febrile patients and key-informant interviews with purposively selected
health workers were conducted at outpatient clinics of health centre IV facilities in Mukono district.
Data entry and analysis were done using EpiData 3.2 and STATA 10 respectively. Data were
described using frequency distributions and proportions. Chi square was used in two by two tables,
odds ratios as the measure of association and an alpha level of 0.05 was used in all significance
tests. Results: Out of 408 respondents, the majority were female (252, 61.8%) and a third of
the samples were aged five years and below. The mean age in years was 3.3 with a standard deviation
of 2.1. More than half of the respondents (359, 88%) utilized malaria diagnostic tests and
about half (241, 59%) received anti-malarial drugs. There were no statistically significant differences
between utilizers and non-utilizers in most characteristics except age, history of indoor residual
spraying and perceived satisfaction with services at outpatient clinics. Utilizers were 75%
less likely to receive anti-malarial drugs than non-utilizers after controlling for age, sex and residence
(OR: 0.25, 95%CI: 0.09, 0.66). Frequent power cut-offs as well as limited knowledge on malaria
treatment guidelines amongst laboratory personnel were some of the major limitations to microscopic diagnosis of malaria. Conclusion: Utilizers were 75% less likely to receive anti-malarial
drugs as opposed to non-utilizers. This implies that increasing utilization of malaria diagnostic
tests can reduce the problem of over-prescription of anti-malarial drugs by 75% among
those tested for malaria, since anti-malarial drugs would be received by only those with a parasitologically-
confirmed diagnosis of malaria. Policy implications: To overcome the problem of overprescription
of anti-malarial drugs, there must be a policy that ensures a consistent power supply
in all public health laboratories. Training of health workers should encompass all cadres and
work-shifts for laboratory personnel should be established to enhance utilization of malaria diagnostic
tests especially at night.
Description
Keywords
Malaria Diagnostic Test, Febrile, Malaria Suspect, Utilizers, Receipt of Anti-Malarial Drugs
Citation
Naigino, R., Katamba, A., Babikako, H.M. and Mukose, A. (2014) Utilization of Malaria Diagnostic Tests and Receipt of Anti-Malarial Drugs by Febrile Patients Attending Outpatient Clinics of Health Centre IV Facilities in Mukono District, Uganda. Health, 6, 1628-1642. http://dx.doi.org/10.4236/health.2014.613195