Gemeinschaftsmedizin und Gesundheitserziehung

Abstrakt

Adherence to Malaria Rapid Diagnostic Test Results and a Qualitative Study on Health Workers' Perception about the Test in Agona East District of Ghana

Selina Ansah-Koi

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. Qualitative aspect involved in depth interviews using purposive sampling 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 workers perceive the RDT as a useful tool which has made malaria diagnosis easy. However, they have little confidence in a negative test result especially in instances where the patients are showing symptoms of malaria. In such situations the health workers are likely to refer the person to a higher facility for microscopy testing, treat for malaria or treat the symptoms and ask the patient to go home and return if the situation gets worse. There is the need for RDTs with high sensitivity and specificity to increase the confidence of health workers regarding negative test results.