Experiences of healthcare personnel on the efficacy of artemisinin-based combination therapy and malaria diagnosis in hospitals in Uganda
Abstract Background The risk of widespread resistance to artemisinin-based combination therapy (ACT) remains high in Uganda following detection of Plasmodium falciparum parasites with delayed artemisinin clearance genotype and phenotype. Establishment of context specific interventions to mitigate em...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-11-01
|
| Series: | Malaria Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12936-023-04800-2 |
| _version_ | 1827604316948529152 |
|---|---|
| author | Moses Ocan Racheal Bakubi Mordecai Tayebwa Joan Basemera Sam Nsobya |
| author_facet | Moses Ocan Racheal Bakubi Mordecai Tayebwa Joan Basemera Sam Nsobya |
| author_sort | Moses Ocan |
| collection | DOAJ |
| description | Abstract Background The risk of widespread resistance to artemisinin-based combination therapy (ACT) remains high in Uganda following detection of Plasmodium falciparum parasites with delayed artemisinin clearance genotype and phenotype. Establishment of context specific interventions to mitigate emergence and spread of artemisinin resistance is thus key in the fight against malaria in the country. The aim of this study was to explore the experiences of healthcare personnel on malaria diagnosis and self-reported efficacy of ACT in the management of malaria symptomatic patients in hospitals in low and high malaria transmission settings in Uganda. Methods This was a qualitative study in which data was collected from healthcare personnel in hospitals using key informant interviews. The key informant interview guide was developed, pre-tested prior to use and covered the following areas, (i) sociodemographic characteristics, (ii) malaria diagnosis (clinical and parasite based), (iii) quality-assured artemisinin-based combination therapy, (iv) malaria patient follow-up, (v) artemisinin resistance, (vi) anti-malarial self-medication. Data was entered in Atlas.ti ver 9.0 and analysis done following a framework criterion. Results A total of 22 respondents were interviewed of which 16 (72.7%) were clinicians. Majority, 81.8% (18/22) of the respondents were male. The following themes were developed from the analysis, malaria diagnosis (procedures and challenges), use of malaria laboratory test results, malaria treatment in hospitals, use of quality assured ACT (QAACT) in malaria treatment, and efficacy of ACT in malaria treatment. Conclusion Most healthcare personnel-initiated malaria treatment after a positive laboratory test. Cases of malaria patients who report remaining symptomatic after prior use of ACT exist especially in high malaria transmission settings in Uganda. There is need for regular monitoring of artemisinin resistance emergence and spread in the country. |
| first_indexed | 2024-03-09T05:57:20Z |
| format | Article |
| id | doaj.art-781e171e6252420382da4dc6b70a2af2 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-03-09T05:57:20Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-781e171e6252420382da4dc6b70a2af22023-12-03T12:12:43ZengBMCMalaria Journal1475-28752023-11-012211910.1186/s12936-023-04800-2Experiences of healthcare personnel on the efficacy of artemisinin-based combination therapy and malaria diagnosis in hospitals in UgandaMoses Ocan0Racheal Bakubi1Mordecai Tayebwa2Joan Basemera3Sam Nsobya4Department of Pharmacology & Therapeutics, College of Health Sciences, Makerere UniversityDepartment of Health Policy, Planning and Management, College of Health Sciences, Makerere UniversityGrants office, College of Health Sciences, Makerere UniversityDepartment of Immunology and Molecular Biology, College of Health SciencesInfectious Disease Research Collaboration (IDRC)Abstract Background The risk of widespread resistance to artemisinin-based combination therapy (ACT) remains high in Uganda following detection of Plasmodium falciparum parasites with delayed artemisinin clearance genotype and phenotype. Establishment of context specific interventions to mitigate emergence and spread of artemisinin resistance is thus key in the fight against malaria in the country. The aim of this study was to explore the experiences of healthcare personnel on malaria diagnosis and self-reported efficacy of ACT in the management of malaria symptomatic patients in hospitals in low and high malaria transmission settings in Uganda. Methods This was a qualitative study in which data was collected from healthcare personnel in hospitals using key informant interviews. The key informant interview guide was developed, pre-tested prior to use and covered the following areas, (i) sociodemographic characteristics, (ii) malaria diagnosis (clinical and parasite based), (iii) quality-assured artemisinin-based combination therapy, (iv) malaria patient follow-up, (v) artemisinin resistance, (vi) anti-malarial self-medication. Data was entered in Atlas.ti ver 9.0 and analysis done following a framework criterion. Results A total of 22 respondents were interviewed of which 16 (72.7%) were clinicians. Majority, 81.8% (18/22) of the respondents were male. The following themes were developed from the analysis, malaria diagnosis (procedures and challenges), use of malaria laboratory test results, malaria treatment in hospitals, use of quality assured ACT (QAACT) in malaria treatment, and efficacy of ACT in malaria treatment. Conclusion Most healthcare personnel-initiated malaria treatment after a positive laboratory test. Cases of malaria patients who report remaining symptomatic after prior use of ACT exist especially in high malaria transmission settings in Uganda. There is need for regular monitoring of artemisinin resistance emergence and spread in the country.https://doi.org/10.1186/s12936-023-04800-2Test-and-treatMalariaRapid diagnostic testMicroscopyMalariaPolicy |
| spellingShingle | Moses Ocan Racheal Bakubi Mordecai Tayebwa Joan Basemera Sam Nsobya Experiences of healthcare personnel on the efficacy of artemisinin-based combination therapy and malaria diagnosis in hospitals in Uganda Malaria Journal Test-and-treat Malaria Rapid diagnostic test Microscopy Malaria Policy |
| title | Experiences of healthcare personnel on the efficacy of artemisinin-based combination therapy and malaria diagnosis in hospitals in Uganda |
| title_full | Experiences of healthcare personnel on the efficacy of artemisinin-based combination therapy and malaria diagnosis in hospitals in Uganda |
| title_fullStr | Experiences of healthcare personnel on the efficacy of artemisinin-based combination therapy and malaria diagnosis in hospitals in Uganda |
| title_full_unstemmed | Experiences of healthcare personnel on the efficacy of artemisinin-based combination therapy and malaria diagnosis in hospitals in Uganda |
| title_short | Experiences of healthcare personnel on the efficacy of artemisinin-based combination therapy and malaria diagnosis in hospitals in Uganda |
| title_sort | experiences of healthcare personnel on the efficacy of artemisinin based combination therapy and malaria diagnosis in hospitals in uganda |
| topic | Test-and-treat Malaria Rapid diagnostic test Microscopy Malaria Policy |
| url | https://doi.org/10.1186/s12936-023-04800-2 |
| work_keys_str_mv | AT mosesocan experiencesofhealthcarepersonnelontheefficacyofartemisininbasedcombinationtherapyandmalariadiagnosisinhospitalsinuganda AT rachealbakubi experiencesofhealthcarepersonnelontheefficacyofartemisininbasedcombinationtherapyandmalariadiagnosisinhospitalsinuganda AT mordecaitayebwa experiencesofhealthcarepersonnelontheefficacyofartemisininbasedcombinationtherapyandmalariadiagnosisinhospitalsinuganda AT joanbasemera experiencesofhealthcarepersonnelontheefficacyofartemisininbasedcombinationtherapyandmalariadiagnosisinhospitalsinuganda AT samnsobya experiencesofhealthcarepersonnelontheefficacyofartemisininbasedcombinationtherapyandmalariadiagnosisinhospitalsinuganda |