Improving rational treatment of malaria: perceptions and influence of RDTs on prescribing behaviour of health workers in southeast Nigeria.

<h4>Introduction</h4>Developments in rapid diagnostic tests (RDTs) have opened new possibilities for improved remote malaria diagnosis that is independent of microscopic diagnosis. Studies in some settings have tried to assess the influence of RDTs on the prescribing behaviour of health...

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Autores principales: Benjamin S C Uzochukwu, Emmanuel Onwujekwe, Nkoli N Ezuma, Ogochukwu P Ezeoke, Miriam O Ajuba, Florence T Sibeudu
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Publicado: Public Library of Science (PLoS) 2011
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spelling oai:doaj.org-article:79db37c267e84873a61ea6b26c0eb0912021-11-18T06:59:34ZImproving rational treatment of malaria: perceptions and influence of RDTs on prescribing behaviour of health workers in southeast Nigeria.1932-620310.1371/journal.pone.0014627https://doaj.org/article/79db37c267e84873a61ea6b26c0eb0912011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21297938/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4>Developments in rapid diagnostic tests (RDTs) have opened new possibilities for improved remote malaria diagnosis that is independent of microscopic diagnosis. Studies in some settings have tried to assess the influence of RDTs on the prescribing behaviour of health workers, but such information is generally lacking in Nigeria and many parts of sub-Saharan Africa. This study analysed health workers' perceptions of RDTs and their potential influence on their prescribing and treatment practices after their introduction.<h4>Methods</h4>The study was conducted in four health centers in the Enugu East local government of Enugu State, Nigeria. All 32 health workers in the health centers where RDTs were deployed were interviewed by field workers. Information was sought on their perception of symptoms-based, RDT-based, and microscopy-based malaria diagnoses. In addition, prescription analysis was carried out on 400 prescriptions before and 12 months after RDT deployment.<h4>Results</h4>The majority of the health workers perceived RDTs to be more effective for malaria diagnosis than microscopy and clinical diagnosis. They also felt that the benefits of RDTs included increased use of RDTs in the facilities and the tendency to prescribe more Artemisinin-based combination therapies (ACTs) and less chloroquine and SP. Some of the health workers experienced some difficulties in the process of using RDT kits. ACTs were prescribed in 74% of RDT-negative results.<h4>Conclusions/significance</h4>RDT-supported malaria diagnosis may have led to the overprescription of ACTs, with the drug being prescribed to people with RDT-negative results. However, the prescription of other antimalarial drugs that are not first-line drugs has been reduced. Efforts should be made to encourage health workers to trust RDT results and prescribe ACTs only to those with positive RDT results. In-depth studies are needed to determine why health workers continue to prescribe ACTs in RDT-negative results.Benjamin S C UzochukwuEmmanuel OnwujekweNkoli N EzumaOgochukwu P EzeokeMiriam O AjubaFlorence T SibeuduPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 1, p e14627 (2011)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Benjamin S C Uzochukwu
Emmanuel Onwujekwe
Nkoli N Ezuma
Ogochukwu P Ezeoke
Miriam O Ajuba
Florence T Sibeudu
Improving rational treatment of malaria: perceptions and influence of RDTs on prescribing behaviour of health workers in southeast Nigeria.
description <h4>Introduction</h4>Developments in rapid diagnostic tests (RDTs) have opened new possibilities for improved remote malaria diagnosis that is independent of microscopic diagnosis. Studies in some settings have tried to assess the influence of RDTs on the prescribing behaviour of health workers, but such information is generally lacking in Nigeria and many parts of sub-Saharan Africa. This study analysed health workers' perceptions of RDTs and their potential influence on their prescribing and treatment practices after their introduction.<h4>Methods</h4>The study was conducted in four health centers in the Enugu East local government of Enugu State, Nigeria. All 32 health workers in the health centers where RDTs were deployed were interviewed by field workers. Information was sought on their perception of symptoms-based, RDT-based, and microscopy-based malaria diagnoses. In addition, prescription analysis was carried out on 400 prescriptions before and 12 months after RDT deployment.<h4>Results</h4>The majority of the health workers perceived RDTs to be more effective for malaria diagnosis than microscopy and clinical diagnosis. They also felt that the benefits of RDTs included increased use of RDTs in the facilities and the tendency to prescribe more Artemisinin-based combination therapies (ACTs) and less chloroquine and SP. Some of the health workers experienced some difficulties in the process of using RDT kits. ACTs were prescribed in 74% of RDT-negative results.<h4>Conclusions/significance</h4>RDT-supported malaria diagnosis may have led to the overprescription of ACTs, with the drug being prescribed to people with RDT-negative results. However, the prescription of other antimalarial drugs that are not first-line drugs has been reduced. Efforts should be made to encourage health workers to trust RDT results and prescribe ACTs only to those with positive RDT results. In-depth studies are needed to determine why health workers continue to prescribe ACTs in RDT-negative results.
format article
author Benjamin S C Uzochukwu
Emmanuel Onwujekwe
Nkoli N Ezuma
Ogochukwu P Ezeoke
Miriam O Ajuba
Florence T Sibeudu
author_facet Benjamin S C Uzochukwu
Emmanuel Onwujekwe
Nkoli N Ezuma
Ogochukwu P Ezeoke
Miriam O Ajuba
Florence T Sibeudu
author_sort Benjamin S C Uzochukwu
title Improving rational treatment of malaria: perceptions and influence of RDTs on prescribing behaviour of health workers in southeast Nigeria.
title_short Improving rational treatment of malaria: perceptions and influence of RDTs on prescribing behaviour of health workers in southeast Nigeria.
title_full Improving rational treatment of malaria: perceptions and influence of RDTs on prescribing behaviour of health workers in southeast Nigeria.
title_fullStr Improving rational treatment of malaria: perceptions and influence of RDTs on prescribing behaviour of health workers in southeast Nigeria.
title_full_unstemmed Improving rational treatment of malaria: perceptions and influence of RDTs on prescribing behaviour of health workers in southeast Nigeria.
title_sort improving rational treatment of malaria: perceptions and influence of rdts on prescribing behaviour of health workers in southeast nigeria.
publisher Public Library of Science (PLoS)
publishDate 2011
url https://doaj.org/article/79db37c267e84873a61ea6b26c0eb091
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