scholarly journals Adherence to malaria rapid diagnostic test results and a qualitative study on Health Workers perception about the test in Agona East District of Ghana

Author(s):  
Selina Ansah-Koi

Abstract Background Ghana has adopted the policy of diagnostically testing for malaria before treatment. The Rapid Diagnostic Test (RDT) is used to diagnose malaria especially in lower health facilities like Health Centers (HC) and Community-based Health Planning Services (CHPS) Compounds without microscopy. Studies have shown that clinicians do not always adhere to negative malaria test results of the RDT and prescribe anti-malarials. Methods Quantitative aspect focused on how malaria is diagnosed and adherence to negative rapid diagnostic test results using the consulting room register and patients’ folder of six health facilities within the period of July to September 2015. In-depth interviews using purposive sampling was conducted for 14 health workers at Health Centers and CHPS compounds to find out their perceptions about malaria RDT and reasons for adherence or non-adherence to test results.Results Of the six health facilities in the Agona East District, 3.87% (14/362) were presumptively diagnosed with malaria whiles 96.10% (348/362) were diagnosed with malaria using RDT.For those tested with RDT, 15.25% tested negative and 84.75% tested positive. Of those who tested negative, 20.75% were given anti-malarials and 79.25% did not receive anti-malarials. Health workers perceived the Malaria RDT kit as easy to use and also as making work easier. Testing is done mainly because it is a policy. Conclusion The malaria testing rate in the Agona East District is higher than that at the National level. Health Centers compared to CHPS compounds are likely to treat for malaria in cases of a negative test result. There is also high adherence to negative test results. Health workers perceive the RDT as a useful tool which has made malaria diagnosis easy.

2015 ◽  
Vol 4 (4) ◽  
pp. 1
Author(s):  
Josephine Michael Shabani ◽  
Iddagiovana Kinyonge ◽  
Hadija Kweka ◽  
Selemani Mbuyiya ◽  
Ahmed Makemba ◽  
...  

Background: Attention to the sustainability of health intervention programs is increasing not only in developing countries but also in developed countries together with international development agencies. However, consensus on operational definitions of sustainability and determinants of sustainability is still at an early stage. While much progress has been made in the development of successful interventions to promote health, too few interventions achieve long term sustainability. Implementation of EMPOWER project in collaboration with World Lung Foundation (WLF) have increased accessibility of comprehensive emergency obstetric care (CEmOC) by upgrading health centers which were formerly not providing CEmOC services in the three rural districts in Tanzania. Although the WHO standards of CEmOC coverage in the project districts was above the requirement, but accessing these health facilities which provides CEmOC was so difficult due to various factors like geographical (mountains, rivers, seasonal roads), locations of these health facilities (like in one district the it was located at a corner of the district), unreliable referral system and poor functionality of these health facilities especially in terms of emergency preparedness etc. all these factors lead to less/poor accessibility to CEmOC. The upgraded facilities include Kibiti in Rufiji district, Mlimba in Kilombero district, Mwaya and Mtimbira in Ulanga district. Objective: To explore challenges of sustaining upgraded health centers and impact on service utilization after project phase out among rural communities in Tanzania.Methods: Purposeful criterion-based selection of the upgraded health centers (those providing CEmOC) was used in the three districts two years after project phase-out. Secondary data analysis of the quantitative data which was collected during and after the project was done. The following services were assessed; total number of facility deliveries, average number of cesarean section (CS), ante natal care (ANC) attendance, post natal care (PNC) attendance, family planning (FP) use and partograph to monitor the progress of labor. Qualitative data involved key informant interviews of council health management teams (CHMT) and facility in charges.Monitoring data, evaluation and observation of various CEmOC and MNCH related indicators were also done. Four upgraded health centers (Mwaya, Mtimbira, Mlimba and Kibiti) were used as case studies to generate learning reported in this paper.Results: Two years post project, the utilization of most of the services like number of deliveries and CS performed better and were maintained in upgraded health centers which receive regular assistance (Mwaya and Mlimba) than Kibiti health center which received minimal support. Health workers remained committed to sustain the practices promoted in the interventionsdespite of the noted challenges.Conclusions: Benefits of introduced health innovations such as upgrading of health centers for CEmOC can only be sustained if a sustainability strategies are integrated at early stages of project design and carried forward in routine district health planning processes.


PLoS ONE ◽  
2019 ◽  
Vol 14 (10) ◽  
pp. e0223869
Author(s):  
Izuchukwu Frank Obi ◽  
Kabiru Sabitu ◽  
Abdulhakeem Olorukooba ◽  
Ayo Stephen Adebowale ◽  
Rabi Usman ◽  
...  

2021 ◽  
pp. 15-17
Author(s):  
Stuti Kansra Arora ◽  
Mala Chhabra ◽  
Anuradha Anuradha ◽  
Arvind Achra ◽  
Nandini Duggal

Introduction:Hepatitis C virus (HCV) infection has emerged as one of the major global health challenge affecting about 2 - 3% of the world population. Epidemiological studies have shown that HCV infection is a major risk factor for development of Acute hepatitis,chronic liver disease,cirrhosis and Hepatocellular carcinoma (HCC).Early diagnosis of HCV is important to link hepatitis testing to care and treatment initiation. Aim:To compare sensitivity and specificity of rapid diagnostic test (RDT) with fourth generation ELISA Material and Method: This study was conducted in the Department of Microbiology at Atal Bihari Vajpayee Institute of Medical Sciences (formerly Post Graduate Institute of Medical Education and Research) and Dr Ram Manohar Lohia Hospital from January 2018 to December 2018.Blood samples of patients suspected with hepatitis were tested using ELISA and rapid diagnostic test Results: In our study 26378 blood samples were tested for HCV,using fourth generation ELISA.Of these,581(2.20%) samples were found to be positive by ELISA.These HCV positive samples along with equal number of ELISA negative samples were tested by rapid diagnostic test. Sensitivity and specificity of the rapid diagnostic test was found to be 72.98 % and 100% respectively. Discussion:Rapid diagnostic test can be used during emergency hours but their results must be followed by ELISA test results in a tertiary care hospital.Reporting of false negative results should be minimized for rapid linkage to treatment initiation and to avoid silent transmission of infection.


Author(s):  
Tokponnon F ◽  
◽  
Osse R ◽  
Houessou C ◽  
Akogbeto M ◽  
...  

Parasitological diagnosis is a fundamental element in the adequate management of the disease. In the last decade, there has been a resurgence of interest in the development of malaria Rapid Diagnostic Test (RDT) kits. This is the case with SD Bioline Malaria Ag Pf, which searches for HRP2 antigen by immunochromatography. The objective of this study is to compare the results of RDT SD Bioline Malaria Ag Pf in use with the results of Thick Gout (TG) in the biological diagnosis of malaria. This was a cross-sectional, descriptive and evaluative study carried out at the Hôpital d’Instruction des Armées-Center Hospitalier et Universitaire de Parakou and at the Boko zone hospital from April 20 to July 30, 2015. Patient identification, we used the non-probabilistic method and the convenience choice technique. The study involved 503 patients. The results of this study showed a good performance of the RDT SD Bioline Malaria Ag Pf. Among the 503 patients, 199 or 39.6% were positive for the RDT against 180 or 35.8% positive for the Thick Gout (TG). Sensitivity, specificity, positive and negative predictive values of the test compared to the thick film were respectively (91.7%, 89.5%, 82.9, 95) and the Kappa coefficient of 0.88 testifies a good match. False positive cases are noted in patients on treatment and even after recovery due to the persistence of the HRP2 antigen in the blood. However, it constitutes an interesting alternative to the management of malaria. At the end of this study, we suggest continuing the use of RDTs in health centers where microscopy is absent and/or reinforcing microscopy, and to strengthen staff training in the management of malaria cases.


Author(s):  
Jessica Gloria Mogi ◽  
Gustaaf A. E. Ratag

Background: The Indonesian government recognizes the importance of mental health issues as indicated by the inclusion of such issues as indicators in the national program, the Healthy Indonesian Program with Family Approach (PIS-PK). This program is enforced in community health centers (puskesmas) in every regency in the country. However, the continually increasing number of mental disorder cases and the intense stigmatization of people with these disorders indicate the need to re-evaluate the capacity and delivery of designated centers’ mental health programs.Methods: This community survey involved interviewing the program directors of four community health centers in north Minahasa using the WHO-AIMS 2.2 questionnaire.Results: Very little effort has been made to improve mental health facilities and programs. Examples of aspects of health facilities that are lacking include training for health workers, the provision of psychotropic drugs, and supported employment or occupational rehabilitation.Conclusions: Community health centers are primary healthcare facilities for society. Therefore, mental health services should be implemented as one of their main programs.


2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Robin Altaras ◽  
Anthony Nuwa ◽  
Bosco Agaba ◽  
Elizabeth Streat ◽  
James K. Tibenderana ◽  
...  

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
George Okello ◽  
Sassy Molyneux ◽  
Scholastica Zakayo ◽  
Rene Gerrets ◽  
Caroline Jones

Abstract Background Routine health information systems can provide near real-time data for malaria programme management, monitoring and evaluation, and surveillance. There are widespread concerns about the quality of the malaria data generated through routine information systems in many low-income countries. However, there has been little careful examination of micro-level practices of data collection which are central to the production of routine malaria data. Methods Drawing on fieldwork conducted in two malaria endemic sub-counties in Kenya, this study examined the processes and practices that shape routine malaria data generation at frontline health facilities. The study employed ethnographic methods—including observations, records review, and interviews—over 18-months in four frontline health facilities and two sub-county health records offices. Data were analysed using a thematic analysis approach. Results Malaria data generation was influenced by a range of factors including human resource shortages, tool design, and stock-out of data collection tools. Most of the challenges encountered by health workers in routine malaria data generation had their roots in wider system issues and at the national level where the framing of indicators and development of data collection tools takes place. In response to these challenges, health workers adopted various coping mechanisms such as informal task shifting and use of improvised tools. While these initiatives sustained the data collection process, they also had considerable implications for the data recorded and led to discrepancies in data that were recorded in primary registers. These discrepancies were concealed in aggregated monthly reports that were subsequently entered into the District Health Information Software 2. Conclusion Challenges to routine malaria data generation at frontline health facilities are not malaria or health information systems specific; they reflect wider health system weaknesses. Any interventions seeking to improve routine malaria data generation must look beyond just malaria or health information system initiatives and include consideration of the broader contextual factors that shape malaria data generation.


2014 ◽  
Vol 13 (1) ◽  
Author(s):  
Sepideh Modrek ◽  
Eric Schatzkin ◽  
Anna De La Cruz ◽  
Chinwoke Isiguzo ◽  
Ernest Nwokolo ◽  
...  

2013 ◽  
Vol 12 (1) ◽  
pp. 49-62 ◽  
Author(s):  
Derryck Klarkowski ◽  
Daniel P O’Brien ◽  
Leslie Shanks ◽  
Kasha P Singh

2020 ◽  
Author(s):  
Ami Pradhan ◽  
Erin Bogue ◽  
Benjamin Schreiber ◽  
Hannah Sarah Dini ◽  
Hitesh Hurkchand ◽  
...  

Abstract Background: This paper explores the extent of community-level stock-out of essential and program commodities for Maternal, Newborn and Child Health (MNCH) among Community Health Workers (CHWs) in Low- and Middle-Income Countries (LMICs), and identifies the underlying bottlenecks leading to such stock-outs.Methods: A systematic literature review was conducted of published and grey literature. 48 studies containing information on the number or percentage of CHWs or health facilities (HFs) stocked-out, or reasons for stock-outs at these levels, were included. In addition, interviews were conducted with domain experts from different organizations working on community health to identify primary reasons for stock-outs. The qualitative data regarding reasons for stock-outs were categorized under different themes, using a content analysis method. Results: 48.09% [CI 95%: 39.28 - 56.90] of the Community Health Workers and 54.76 % [CI 95%: 43.54 - 65.98] of the health facilities in SSA countries included in this study experienced stock-outs of essential commodities. A hypothesis test showed no significant difference in stock-out rates between CHWs and HFs. The most frequently cited reason for CHW stock-outs was a lack of financial resources, leading to inadequate national level stocks, affecting supply available at the last mile. Moreover, issues at HF and CHW levels in the following areas contributed to stock-outs: transportation, data and estimation of needs, human resources, and stock management and storage. These significant bottlenecks hinder the ability of CHWs to save lives.Conclusion: Stock-outs of health commodities impact almost half of CHWs, preventing effective service delivery. Many factors contribute to stock-outs, which occur at all levels of the health supply chain. A system strengthening approach is necessary to reduce CHW stock-outs. Sparse data, differing definitions of stock-outs, and inconsistent reporting metrics posed significant challenges to analyzing results from reviewed studies. Therefore, a set of standard metrics to measure the rate, period, and frequency of stock-outs in future studies is recommended.


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