Malaria Diagnosis and Treatment Practices in Public Primary Health Care Clinics in Pankshin Local Government Area, Plateau State, Nigeria.

Abstract

Background: Malaria remains the most important infectious disease in sub-Saharan Africa. Over exposure of the parasite to antimalarial medicines has precipitated the emergence of drug resistance to these medicines. The World Health Organization in 2010 issued a new policy of universal parasite-based diagnosis as a prerequisite for treatment. This study aimed at determining if Primary Health Care workers in Pankshin Local Government Area are complying with the new policy.

 Methods: Using stratified sampling technique, six clinics were selected from Pankshin Local Government Area. Relevant information on all patients treated for malaria between 1st May 2015 and 30th April 2016 was extracted from clinic records. All health workers who attended to patients were interviewed while a facility inventory form was used to collect information on availability of drugs and supplies. Data generated were analyzed using Statistical Package for Social Sciences version 20.

Results: Out of 2909 patients studied, only 37.3% were tested for malaria parasites before treatment; 68.4% of whom had microscopy while 20.5% had Rapid Diagnostic Test. For those not tested 22.5% had Artemisinin Combination Therapy while 48.1% had non-Artemisinin Combination Therapy. Out of those who tested negative for malaria parasite, 8.8% and 21.6% were treated with Artemisinin Combination Therapy and non-Artemisinin Combination Therapy respectively Those who tested positive received Artemisinin Combination Therapy alone (35.5%) or in combination with other drugs (64.5%). Testing influenced the choice of drug for malaria treatment and this was statistically significant (p < 0.001).

Conclusion:  Pretreatment testing for malaria and adherence to test results in Primary Health Care clinics in Pankshin are low. Concerted efforts are required for their training and supervision on the current guidelines on malaria diagnosis and treatment.