Health workers’ perception of malaria rapid diagnostic test and factors influencing compliance with test results in Ebonyi state, Nigeria.Data.xlsx

Summary of study

Background:
The standard practice in treating uncomplicated malaria is to prescribe
artemisinin-based combination therapy (ACT) for only patients with
positive test results. However, health workers (HWs) sometimes prescribe
ACTs for patients with negative malaria rapid diagnostic test (mRDT)
results. Available evidence on HWs perception of mRDT and their level of
compliance with test results in Nigeria lacks adequate stratification
by state and context. We assessed HWs perception of mRDT and factors
influencing ACTs prescription to patients with negative mRDT results in
Ebonyi state, Nigeria.

Methods: A
cross-sectional survey was conducted among 303 HWs who treat suspected
malaria patients in 40 randomly selected public and private health
facilities in Ebonyi state. Health workers’ perception of mRDT was
assessed with 18 equally weighted five-point likert scale questions with
maximum obtainable total score of 90. Scores ≥72 were graded as good
and less, as poor perception. Data were analysed using descriptive
statistics and logistic regression model at 5% significance level.

Results: Mean
age of respondents was 34.6±9.4 years, 229 (75.6%) were females, 180
(59.4%) community health workers and 67 (22.1%) medical doctors.
Overall, 114 (37.6%) respondents across healthcare facility strata had
poor perception of mRDT. Respondents who prescribed ACTs to patients
with negative mRDT results within six months preceding the survey were
154 (50.8%) [PHCs: 50 (42.4%), General hospitals: 18 (47.4%), tertiary
facility: 51 (79.7%) and missionary hospitals: 35 (42.2%)]. Poor HWs’
perception of mRDT promoted prescription of ACT to patients with
negative mRDT results (AOR=5.6, 95% C.I= 3.2 - 9.9). The likelihood of
prescribing ACTs to patients with negative mRDT results was higher among
HWs in public health facilities (AOR=2.8, 95% C.I=1.4 - 5.5) than those
in the private.

Conclusions: The poor perception
of mRDT and especially common prescribing of ACTs to patients with
negative mRDT results among HWs in Ebonyi state, calls for context
specific interventions to improve their perception and compliance with
mRDT test results.