Exploring patients’ viewpoints on uncomplicated malaria and its management in primary healthcare facilities of Plateau State, Nigeria: a qualitative study

Malaria infection is a major public health problem in Nigeria. The present study explored patients’ thoughts and feelings on uncomplicated malaria and its management practices in some primary healthcare (PHC) facilities of Plateau state, Nigeria. An in-depth interview was conducted on patients receiving treatment in some of the facilities in the state, who were recruited through purposive sampling method up to saturation point. All the information was audio-recorded and transcribed verbatim before analysis using the principles of thematic content analysis of inductive method. Generally, their views on malaria-related issues were categorised into four main themes based on their relevancies as: patients’ perceptions on malaria infection and anti-malarial drugs, the role of healthcare workers and family during treatment, medications taken and socio-economic-related factors, as well as their general views on healthcare facilities-related factors. The study showed patients’ perceptions of the aforementioned factors as influencing their treatment and management practices of the disease in the study area. Necessary interventions that would improve patients’ quality of management of the disease toward achieving the desired outcome of therapy are recommended.

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Predictors of patients' knowledge, attitudes and practices (KAP) regarding uncomplicated malaria in the primary healthcare facilities of Plateau state, Nigeria

Journal of Health Research ◽

10.1108/jhr-06-2019-0125 ◽

2020 ◽

Vol 34 (4) ◽

pp. 329-344 ◽

Cited By ~ 1

Author(s):

Nanloh Samuel Jimam ◽

Nahlah Elkudssiah Ismail

Keyword(s):

Primary Healthcare ◽

Uncomplicated Malaria ◽

Design Methodology ◽

Content Type ◽

Healthcare Facilities ◽

Attitudes And Practices ◽

Intervention Measures ◽

Therapeutic Outcomes ◽

Plateau State ◽

Knowledge Attitudes And Practices

PurposeThis study determined factors that influenced patients' knowledge, attitudes and practices (KAP) regarding uncomplicated malaria in primary healthcare (PHC) facilities of Plateau state, Nigeria.Design/methodology/approachThe data of 956 patients treated for uncomplicated malaria in PHC facilities of Plateau state were used for the study. Inferential statistical analyses were conducted to identify factors that influenced patients' KAP on the disease and its management.FindingsThe study revealed age (p < 0.001), level of education (p = 0.012), attitudes (p = 0.007) and practices (p < 0.001) as significant predictors of knowledge outcomes on uncomplicated malaria, while their attitudes towards the disease and its management was predicted by their gender (p = 0.011), occupation (p = 0.049), monthly income (p = 0.018), knowledge (p < 0.001) and practices (p < 0.001). Furthermore, their practices were significantly predicted by monthly incomes (p = 0.043), knowledge (p < 0.001), attitudes (p < 0.001) and number of anti-malarial and adjunct drugs administered to them (p = 0.041).Originality/valueThe study revealed a mixed influence of patients' characteristics on their KAP outcomes. This calls for appropriate intervention measures towards achieving the desired patients' therapeutic outcomes.

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Haematological profile of children with malaria in Sorong, West Papua, Indonesia

Malaria Journal ◽

10.1186/s12936-021-03638-w ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Syilvia Jiero ◽

Ayodhia Pitaloka Pasaribu

Keyword(s):

Malaria Infection ◽

Clinical Symptoms ◽

Public Health Problem ◽

Malaria Diagnosis ◽

White Blood Count ◽

P Value ◽

Major Public Health Problem ◽

Age Group ◽

Haematological Profile ◽

West Papua

Abstract Background Malaria remains a major public health problem in Indonesian Papua, with children under five years of age being the most affected group. Haematological changes, such as cytopenia that occur during malaria infection have been suggested as potential predictors and can aid in the diagnosis of malaria. This study aimed to assess the haematological alterations associated with malaria infection in children presenting with signs and symptoms of malaria. Methods A retrospective study was performed by collecting data from the medical records of malaria patients at Sorong Regional General Hospital, Sorong, West Papua, Indonesia, both from outpatient and inpatient clinics, from January 2014 until December 2017. The laboratory profile of children suffering from malaria was evaluated. Results One hundred and eighty-two children aged 1 month to 18 years old were enrolled. The subjects were mostly male (112, 61.5%) with a mean age of 6.45 years (SD = 4.3 years). Children below 5 years of age suffered the most from malaria in this study (77, 42.3%). One hundred two subjects (56%) were infected with Plasmodium falciparum. Half of the enrolled subjects (50%) had haemoglobin level (Hb) between 5.1 and 10 gr/dL. A total of 41 children (53.2%) less than 5 years old suffered from P. falciparum infection. In the age group of 5–10 years, there were 34 children (57.6%) who suffered from P. falciparum, and in the age group > 10 years, 27 children (58.7%) suffered from P. falciparum infection. Only 4 subjects (5.2%) in the less than 5 years old age group had mixed malaria infection. Among eight predictors of the haematological profile, there were five predictors that were significantly associated with the diagnostic criteria, namely haemoglobin, haematocrit, leukocytes, platelets and monocytes (p < 0.05). Generally, clinical symptoms are not significantly associated with a malaria diagnosis, and only one variable showed a significant relationship, pale, with a P value of 0.001. Conclusions Children with malaria had changes in some haematological markers, with anaemia, low platelet count, white blood count, and lymphocyte count being the most important predictors of malaria infection in the study area. These markers could be used to raise suspicion of malaria in children living in high endemic areas, such as West Papua.

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Abstract P221: Effect Of Instructional Videos To Enhance Healthcare Provider Knowledge For Hypertension (htn) Management In Tanzania

Hypertension ◽

10.1161/hyp.78.suppl_1.p221 ◽

2021 ◽

Vol 78 (Suppl_1) ◽

Author(s):

Anbrasi Edward ◽

Gibson Kagaruki ◽

Frank Manase ◽

Kuni Matsushita ◽

Lawrence J Appel

Keyword(s):

Healthcare Provider ◽

Low Cost ◽

Public Health Problem ◽

Major Public Health Problem ◽

Healthcare Facilities ◽

Instructional Videos ◽

Adequate Knowledge ◽

Provider Knowledge ◽

Knowledge Competencies ◽

Instructional Training

Introduction: The growing burden of HTN is a major public health problem in Tanzania, with the estimated prevalence of 28%. The healthcare system faces major capacity constraints, including inadequate provider competencies; <60% of providers reported fair knowledge of HTN, and only 42% had access to HTN guidelines. Knowledge of HTN management standards and guidelines is prerequisite to improving HTN management. Objective: Determine the effect of instructional training videos in improving healthcare provider knowledge for HTN management. Methods: Eighteen primary healthcare facilities in the Dar es Salaam region were selected using stratified random sampling. In each facility, providers, who screened and managed patients for HTN, completed pre-test knowledge assessments. Subsequently, they were invited to an instructional training, using four, 4-5minute videos developed by investigators at Johns Hopkins. Post-test was conducted 5 months after the introduction of the videos. Results: Thirty-three clinicians participated in the pre-post study and consented to attending the video training workshop. Knowledge competencies showed significant improvement in most but not all aspects of HTN management (Table). For example, adequate knowledge about HTN increased from 78.8% to 100% (p<0.01), and knowledge of patient preparation prior to Blood Pressure (BP) screening increased from 69.7% to 93.9% ( p<0.05). Conclusion: In the context of a resource-constrained setting, low-cost training videos have the potential to improve healthcare provider knowledge for HTN management.

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An Overview of Pain Management

Journal of Medical Regulation ◽

10.30770/2572-1852-91.2.20 ◽

2005 ◽

Vol 91 (2) ◽

pp. 20-30

Author(s):

June L. Dahl

Keyword(s):

Pain Management ◽

Pain Assessment ◽

Management Practices ◽

Public Health Problem ◽

The United States ◽

Basic Knowledge ◽

Rational Approach ◽

Major Public Health Problem ◽

Pharmacologic Treatments ◽

Control Pain

ABSTRACT In spite of major advances in pain management practices, the undertreatment of pain remains a major public health problem in the United States. A basic knowledge of pain assessment and management is critical to removing the barriers that are responsible for poor pain control. Pain assessment is the essential first step in the management of any type of pain as it guides the development of a rational approach to treatment. Pharmacologic therapies are often essential to successful pain management. Three major classes of pain medications are available: non-opioids, opioids, and adjuvant analgesics for special pain problems. This paper provides an overview of the various drugs in each of these classes as well as recommendations to guide their use. The goal of therapy is to reduce pain and improve function. A comprehensive approach to pain management should be based on the use of multimodal therapy, rational combinations of pharmacologic and non-pharmacologic treatments.

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Medical practitioner’s knowledge on dengue management and clinical practices in Bhutan

PLoS ONE ◽

10.1371/journal.pone.0254369 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0254369

Author(s):

Tsheten Tsheten ◽

Archie C. A. Clements ◽

Darren J. Gray ◽

Kinley Gyeltshen ◽

Kinley Wangdi

Keyword(s):

Clinical Management ◽

Management Practices ◽

Health Workers ◽

Public Health Problem ◽

Fluid Replacement ◽

Severe Dengue ◽

Warning Sign ◽

Major Public Health Problem ◽

Clinical Practices ◽

Health Council

Background Dengue has emerged as a major public health problem in Bhutan, with increasing incidence and widening geographic spread over recent years. This study aimed to investigate the knowledge and clinical management of dengue among medical practitioners in Bhutan. Methods We administered a survey questionnaire to all practitioners currently registered under the Bhutan Medical and Health Council. The questionnaire contained items on four domains including transmission, clinical course and presentation, diagnosis and management, and surveillance and prevention of dengue. Participants were able to respond using an online Qualtrics survey, with the invitation and link distributed via email. Results A total of 97 respondents were included in the study (response rate: 12.7%), of which 61.86% were Health Assistants/Clinical Officers (HAs/COs) and 38.14% were medical doctors. The afternoon feeding behaviour of Aedes mosquito was correctly identified by only 24.7% of the respondents, and ~66.0% of them failed to identify lethargy as a warning sign for severe dengue. Knowledge on diagnosis using NS1 antigen and the clinical significance of elevated haematocrit for initial fluid replacement was strikingly low at 47.4% and 27.8% respectively. Despite dengue being a nationally notifiable disease, ~60% of respondents were not knowledgeable on the timing and type of cases to be reported. Respondent’s median score was higher for the surveillance and reporting domain, followed by their knowledge on transmission of dengue. Statistically significant factors associated with higher knowledge included respondents being a medical doctor, working in a hospital and experience of having diagnosed dengue. Conclusion The study revealed major gaps on knowledge and clinical management practices related to dengue in Bhutan. Physicians and health workers working in Basic Health Units need training and regular supervision to improve their knowledge on the care of dengue patients.

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System Delay in Breast Cancer Diagnosis in Gaza Strip, Palestine

Journal of Oncology ◽

10.1155/2019/5690938 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Samira S. Abo Al-Shiekh ◽

Yasser S. Alajerami ◽

Bothyna B. Etewa ◽

Aymen M. Elsous

Keyword(s):

Breast Cancer ◽

Breast Imaging ◽

Gaza Strip ◽

Diagnostic Delay ◽

Public Health Problem ◽

Diagnostic Tools ◽

Major Public Health Problem ◽

Related Factors ◽

The Gaza Strip

Background. Breast cancer is a major public health problem and the first leading cause of cancer deaths among females in Palestine. Early diagnosis of breast cancer contributes to reduction of morbidity and mortality rates. This study aimed to explore system-related factors affecting the timely diagnosis of breast cancer in the Gaza Strip. Method and Materials. A mixed method, sequential explanatory design was employed. A quantitative study was conducted first, and it was cross-sectional in nature, followed by a qualitative study. An interviewed questionnaire and an abstraction sheet were used to collect necessary quantitative data among 122 females diagnosed with breast cancer. A purposive sample of five medical specialists were selected for in-depth interview. Descriptive and inferential analyses were used to find differences between variables. Odds ratio and confidence interval at 95% were presented, and P<0.05 was considered statistically significant. Results. Around 12.3% of women experienced diagnostic delay for 3 months and more, and 6.6% reported a delay in referral for more than 2 weeks. Regarding imaging delay, around 8.2% and 2.7% of women had reported a delay in performing mammography and ultrasound, respectively. Moreover, one-fourth reported delay in performing biopsy for more than 14 days, and 46.3% reported delay more than 14 days in getting histopathology report. In addition, 9% missed the follow-up after benign findings of the previous breast imaging and no national protocols are available for the diagnosis of breast cancer in the Gaza strip. Conclusion. There is a long appointment time for diagnostic tools especially in biopsy. The nonmalignant findings from mammography or ultrasound could affect diagnosis time. It is an urgent need to have a national protocol for diagnosis and management of breast cancer and to adopt screening, diagnostic, and follow-up programs under the supervision of the Ministry of Health.

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Assessing Related Factors of Intention to Perpetrate Dating Violence among University Students Using the Theory of Planned Behavior

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17030923 ◽

2020 ◽

Vol 17 (3) ◽

pp. 923

Author(s):

Wen-Li Hou ◽

Chung-Ying Lin ◽

Yu-Ming Wang ◽

Ying-Hua Tseng ◽

Bih-Ching Shu

Keyword(s):

Theory Of Planned Behavior ◽

University Students ◽

Planned Behavior ◽

Dating Violence ◽

Structural Equation ◽

Behavioral Control ◽

Public Health Problem ◽

Perceived Behavioral Control ◽

Major Public Health Problem ◽

Related Factors

Dating violence (DV) is a major public health problem among youth. The majority of DV studies in Taiwan involve the assessment of DV without the use of a robust psychological framework to guide research accuracy. Therefore, the purpose of this study was to utilize the Theory of Planned Behavior (TPB) to assess intention and other salient factors related to DV among university students. A two-phase, mixed-method design study was conducted among university students from seven universities in Taiwan, aged 18 to 24 years. In Phase I, questionnaires used were specifically developed based on the TPB, consisting of both direct and indirect measures related to DV. In Phase Ⅱ, questionnaire evaluation and related factors were examined through a two-step process of structural equation modelling (SEM) to test the TPB model. The results of this study found that perceived behavioral control, subjective norm, and attitude toward DV on behavioral intention accounting for 37.5% of the total variance. Among the related factors, attitude toward the behavior was the strongest (β = 0.48, p < 0.001), followed by perceived behavioral control (β = 0.19, p < 0.05). Findings from this study could expand the knowledge base in this important area and might help prevent DV.

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Hematological Profile of Children With Malaria in Sorong, West Papua, Indonesia

10.21203/rs.3.rs-98603/v2 ◽

2021 ◽

Author(s):

Syilvia Jiero ◽

Ayodhia Pitaloka Pasaribu

Keyword(s):

Malaria Infection ◽

Clinical Symptoms ◽

Public Health Problem ◽

Malaria Diagnosis ◽

White Blood Count ◽

P Value ◽

Major Public Health Problem ◽

Age Group ◽

Haematological Profile ◽

West Papua

Abstract Background Malaria remains a major public health problem in Indonesian Papua, with children under five years of age being the most affected group. Haematological changes, such as cytopenia that occur during malaria infection have been suggested as potential predictors and can aid in the diagnosis of malaria. This study aimed to assess the haematological alterations associated with malaria infection in children presenting with signs and symptoms of malaria.Methods A retrospective study was performed by collecting data from the medical records of malaria patients at Sorong Regional General Hospital, Sorong, West Papua, Indonesia, both from outpatient and inpatient clinics, from January 2014 until December 2017. The laboratory profile of children suffering from malaria was evaluated. Results One hundred and eighty-two children aged 1 month to 18 years old were enrolled. The subjects were mostly male (112, 61.5%) with a mean age of 6.45 years (SD = 4.3 years). Children below 5 years of age suffered the most from malaria in this study (77,42.3%). One hundred two subjects (56%) were infected with Plasmodium falciparum. Half of the enrolled subjects (50%) had haemoglobin level (Hb) between 5.1 and 10 gr/dL. A total of 41 children (53.2%) less than 5 years old suffered from P. falciparum infection. In the age group of 5-10 years, there were 34 children (57.6%) who suffered from P. falciparum, and in the age group >10 years, 27 children (58.7%) suffered from P. falciparum infection. Only 4 subjects (5.2%) in the less than 5 years old age group had mixed malaria infection. Among eight predictors of the haematological profile, there were five predictors that were significantly associated with the diagnostic criteria, namely haemoglobin, haematocrit, leukocytes, platelets and monocytes (p <0.05). Generally, clinical symptoms are not significantly associated with a malaria diagnosis, and only one variable showed a significant relationship, pale, with a P value of 0.001. Conclusions Children with malaria had changes in some haematological markers, with anaemia, low platelet count, white blood count, and lymphocyte count being the most important predictors of malaria infection in the study area. These markers could be used to raise suspicion of malaria in children living in hogh endemic areas, such as West Papua.

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Malaria management in animal model using antioxidant vitamins

Nigerian Journal of Parasitology ◽

10.4314/njpar.v41i1.9 ◽

2020 ◽

Vol 41 (1) ◽

pp. 56-59

Author(s):

B.N. Esimai ◽

O.O. Njoku ◽

C.I. Eneanya

Keyword(s):

Animal Model ◽

Malaria Infection ◽

Standard Dose ◽

Public Health Problem ◽

Antioxidant Vitamins ◽

Control Group ◽

Major Public Health Problem ◽

Untreated Control Group ◽

Percent Mortality ◽

The Brain

Management of malaria has become a major public health problem with the emergence of Plasmodium falciparum resistant malaria to most antimalaria drugs. The work was employed to evaluate the management of malaria infection with the use of antioxidant vitamins in animal model. Gnotobiotically reared male Swiss albino mice, aged six to eight weeks, and weighed between 18 and 22 g were inoculated with a standard dose of malaria parasites P. berghei, through intra-peritoneal route. Malaria infected mice were treated over three days with 300 mg base Vitamin A, and 500 mg base vitamin C and E respectively, per kilogram body weight. There was a highly significant decrease (p<0.0001) in parasitaemia in treatedgroups. In positive untreated control group, hundred percent mortality was recorded. Post mortem examinations revealed haemorrhagic lesions at the lower part of the brain. An effective treatment of malaria was noted with orthomolecular management. Keywords: Plasmodium berghei; animal model; malaria; antioxidant vitamins.

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Monitoring of efficacy, tolerability and safety of artemether–lumefantrine and artesunate–amodiaquine for the treatment of uncomplicated Plasmodium falciparum malaria in Lambaréné, Gabon: an open-label clinical trial

Malaria Journal ◽

10.1186/s12936-019-3015-4 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

Bayode R. Adegbite ◽

Jean R. Edoa ◽

Yabo J. Honkpehedji ◽

Frejus J. Zinsou ◽

Jean C. Dejon-Agobe ◽

...

Keyword(s):

Clinical Trial ◽

Drug Resistance ◽

Plasmodium Falciparum ◽

Molecular Markers ◽

Uncomplicated Malaria ◽

Artemisinin Resistance ◽

Public Health Problem ◽

World Health ◽

Major Public Health Problem ◽

Open Label

Abstract Background Malaria remains a major public health problem, affecting mainly low-and middle-income countries. The management of this parasitic disease is challenged by ever increasing drug resistance. This study, investigated the therapeutic efficacy, tolerability and safety of artemether–lumefantrine (AL) and artesunate–amodiaquine (AS–AQ), used as first-line drugs to treat uncomplicated malaria in Lambaréné, Gabon. Methods A non-randomized clinical trial was conducted between October 2017 and March 2018 to assess safety, clinical and parasitological efficacy of fixed-doses of AL and AS–AQ administered to treat uncomplicated Plasmodium falciparum malaria in children aged from 6 months to 12 years. After 50 children were treated with AL, another 50 children received ASAQ. The 2009 World Health Organization protocol for monitoring of the efficacy of anti‑malarial drugs was followed. Molecular markers msp1 and msp2 were used to differentiate recrudescence and reinfection. For the investigation of artemisinin resistant markers, gene mutations in Pfk13 were screened. Results Per-protocol analysis on day 28 showed a PCR corrected cure rate of 97% (95% CI 86–100) and 95% (95% CI 84–99) for AL and AS–AQ, respectively. The most frequent adverse event in both groups was asthenia. No mutations in the kelch-13 gene associated with artemisinin resistance were identified. All participants had completed microscopic parasite clearance by day 3 post-treatment. Conclusion This study showed that AL and AS–AQ remain efficacious, well-tolerated, and are safe to treat uncomplicated malaria in children from Lambaréné. However, a regular monitoring of efficacy and a study of molecular markers of drug resistance to artemisinin in field isolates is essential. Trial registration ANZCTR, ACTRN12616001600437. Registered 18 November, http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12616001600437p&isBasic=True

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