Knowledge, attitude, and practice of the National Guidelines for Diagnosis and Treatment of Malaria among medical doctors in Ebonyi state, Nigeria: A cross-sectional survey

Background The Guidelines for Diagnosis and Treatment of Malaria are meant to guide medical practitioners to enhance optimal management of patients suspected of having malaria which is vital to malarial control and elimination. Medical doctors have the main responsibility for treating patients with malaria so there was need to evaluate the extent to which the medical doctors in Ebonyi state, Nigeria, knew, viewed, and practiced the 2015 National Guidelines for Diagnosis and Treatment of Malaria. Methods A cross-sectional survey was carried out in May, 2019 among medical doctors who were involved in the management of malaria patients and selected via convenience sampling. Data was collected using a structured self-administered questionnaire. Each respondent was categorized as having poor, fair, or good knowledge, attitude, and practice respectively based on knowledge, attitude, and practice scores of 75%. Associated factors were evaluated through bivariate and multivariate binomial logistic regressions at 5% probability of type one error and the overall test for the effect of each independent factor on practice level was done using the "postestimation test" command in Stata. Results A total of 156 medical doctors were surveyed. Most, 138 (88.5%) were aware there was a national guideline for diagnosis and treatment of malaria. Among the medical doctors, 19 (12.2%) had good knowledge, 110 (70.5%) had fair knowledge, and 27 (17.3%) had poor knowledge; 38 (24.4%) had good attitude, 74 (47.4%) had fair attitude, and 44 (28.2%) had poor attitude; and 59 (37.8%) had good practice, 90 (57.7%) had fair practice, and 7 (4.5%) had poor practice. The attitude level of the medical doctors toward the 2015 National Guidelines for Diagnosis and Treatment of Malaria was a predictor of good practice (adjusted p-value of overall effect = 0.0003). Conclusions Although most of the medical doctors in Ebonyi state, Nigeria, were aware of the existence of a national guideline, only just over a third of them had good practice of the 2015 National Guidelines for Diagnosis and Treatment of Malaria. Policy interventions should focus on improving the attitude of the medical doctors toward the National Guidelines through training and re-training.