Acceptability of rapid diagnostic test-based management of Malaria among caregivers of under-five children in rural Ghana
WHO now recommends test-based management of malaria (TBMM) across all age-groups. This implies artemisinin-based combination treatment (ACT) should be restricted to rapid diagnostic test (RDT)-positive cases. This is a departure from what caregivers in rural communities have been used to for many ye...
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| Veröffentlicht in: | PloS one 2012-09, Vol.7 (9), p.e45556-e45556 |
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| creator | Baiden, Frank Owusu-Agyei, Seth Okyere, Eunice Tivura, Mathilda Adjei, George Chandramohan, Daniel Webster, Jayne |
| description | WHO now recommends test-based management of malaria (TBMM) across all age-groups. This implies artemisinin-based combination treatment (ACT) should be restricted to rapid diagnostic test (RDT)-positive cases. This is a departure from what caregivers in rural communities have been used to for many years.
We conducted a survey among caregivers living close to 32 health centres in six districts in rural Ghana and used logistic regression to explore factors likely to influence caregiver acceptability of RDT based case management and concern about the denial of ACT on account of negative RDT results. Focus group discussions were conducted to explain the quantitative findings and to elicit further factors.
A total of 3047 caregivers were interviewed. Nearly all (98%) reported a preference for TBMM over presumptive treatment. Caregivers who preferred TBMM were less likely to be concerned about the denial of ACT to their test-negative children (O.R. 0.57, 95%C.I. 0.33-0.98). Compared with caregivers who had never secured national health insurance cover, caregivers who had valid (adjusted O.R. 1.30, 95% CI 1.07-1.61) or expired (adjusted O.R. 1.38, 95% CI 1.12-1.73) insurance cover were more likely to be concerned about the denial of ACT to their RDT-negative children. Major factors that promote TBMM acceptability include the perception that a blood test at health centre level represents improvement in the quality of care, leads to improvement in treatment outcomes, and offers opportunity for better communication between health workers and caregivers. Acceptability is also enhanced by engaging caregivers in the procedures of the test. Apprehensions about negative health worker attitude could however undermine acceptance.
Test (RDT)-based management of malaria in under-five children is likely to be acceptable to caregivers in rural Ghana. The quality of caregiver-health worker interaction needs to be improved if acceptability is to be sustained. |
| doi_str_mv | 10.1371/journal.pone.0045556 |
| format | Article |
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We conducted a survey among caregivers living close to 32 health centres in six districts in rural Ghana and used logistic regression to explore factors likely to influence caregiver acceptability of RDT based case management and concern about the denial of ACT on account of negative RDT results. Focus group discussions were conducted to explain the quantitative findings and to elicit further factors.
A total of 3047 caregivers were interviewed. Nearly all (98%) reported a preference for TBMM over presumptive treatment. Caregivers who preferred TBMM were less likely to be concerned about the denial of ACT to their test-negative children (O.R. 0.57, 95%C.I. 0.33-0.98). Compared with caregivers who had never secured national health insurance cover, caregivers who had valid (adjusted O.R. 1.30, 95% CI 1.07-1.61) or expired (adjusted O.R. 1.38, 95% CI 1.12-1.73) insurance cover were more likely to be concerned about the denial of ACT to their RDT-negative children. Major factors that promote TBMM acceptability include the perception that a blood test at health centre level represents improvement in the quality of care, leads to improvement in treatment outcomes, and offers opportunity for better communication between health workers and caregivers. Acceptability is also enhanced by engaging caregivers in the procedures of the test. Apprehensions about negative health worker attitude could however undermine acceptance.
Test (RDT)-based management of malaria in under-five children is likely to be acceptable to caregivers in rural Ghana. The quality of caregiver-health worker interaction needs to be improved if acceptability is to be sustained.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0045556</identifier><identifier>PMID: 23029094</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acceptability ; Acceptance tests ; Adult ; Age ; Artemisinin ; Attitude of Health Personnel ; Blood ; Care and treatment ; Caregivers ; Caregivers - psychology ; Child, Preschool ; Children ; Diagnosis ; Diagnostic systems ; Diagnostic tests ; Diagnostic Tests, Routine - methods ; Disease control ; Ghana ; Health care facilities ; Health centres ; Health facilities ; Health Impact Assessment ; Health services ; Humans ; Illnesses ; Infant ; Insurance ; Internal customers ; Interviews as Topic ; Laboratories ; Low income groups ; Malaria ; Malaria - diagnosis ; Management ; Medical diagnosis ; Medical examination ; Medical personnel ; Medical research ; Medicine ; Microscopy ; Middle Aged ; Primary care ; Principal components analysis ; Rural areas ; Rural communities ; Rural Population ; Surveys and Questionnaires ; Vector-borne diseases ; Workers ; Young Adult</subject><ispartof>PloS one, 2012-09, Vol.7 (9), p.e45556-e45556</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>Baiden et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2012 Baiden et al 2012 Baiden et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-5ebd4512357cae7b9a5aba5b2bfda3ae328058a1a43c2d40f55af16636ced6823</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445487/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445487/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23029094$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Noor, Abdisalan Mohamed</contributor><creatorcontrib>Baiden, Frank</creatorcontrib><creatorcontrib>Owusu-Agyei, Seth</creatorcontrib><creatorcontrib>Okyere, Eunice</creatorcontrib><creatorcontrib>Tivura, Mathilda</creatorcontrib><creatorcontrib>Adjei, George</creatorcontrib><creatorcontrib>Chandramohan, Daniel</creatorcontrib><creatorcontrib>Webster, Jayne</creatorcontrib><title>Acceptability of rapid diagnostic test-based management of Malaria among caregivers of under-five children in rural Ghana</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>WHO now recommends test-based management of malaria (TBMM) across all age-groups. This implies artemisinin-based combination treatment (ACT) should be restricted to rapid diagnostic test (RDT)-positive cases. This is a departure from what caregivers in rural communities have been used to for many years.
We conducted a survey among caregivers living close to 32 health centres in six districts in rural Ghana and used logistic regression to explore factors likely to influence caregiver acceptability of RDT based case management and concern about the denial of ACT on account of negative RDT results. Focus group discussions were conducted to explain the quantitative findings and to elicit further factors.
A total of 3047 caregivers were interviewed. Nearly all (98%) reported a preference for TBMM over presumptive treatment. Caregivers who preferred TBMM were less likely to be concerned about the denial of ACT to their test-negative children (O.R. 0.57, 95%C.I. 0.33-0.98). Compared with caregivers who had never secured national health insurance cover, caregivers who had valid (adjusted O.R. 1.30, 95% CI 1.07-1.61) or expired (adjusted O.R. 1.38, 95% CI 1.12-1.73) insurance cover were more likely to be concerned about the denial of ACT to their RDT-negative children. Major factors that promote TBMM acceptability include the perception that a blood test at health centre level represents improvement in the quality of care, leads to improvement in treatment outcomes, and offers opportunity for better communication between health workers and caregivers. Acceptability is also enhanced by engaging caregivers in the procedures of the test. Apprehensions about negative health worker attitude could however undermine acceptance.
Test (RDT)-based management of malaria in under-five children is likely to be acceptable to caregivers in rural Ghana. The quality of caregiver-health worker interaction needs to be improved if acceptability is to be sustained.</description><subject>Acceptability</subject><subject>Acceptance tests</subject><subject>Adult</subject><subject>Age</subject><subject>Artemisinin</subject><subject>Attitude of Health Personnel</subject><subject>Blood</subject><subject>Care and treatment</subject><subject>Caregivers</subject><subject>Caregivers - psychology</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Diagnostic tests</subject><subject>Diagnostic Tests, Routine - methods</subject><subject>Disease control</subject><subject>Ghana</subject><subject>Health care facilities</subject><subject>Health centres</subject><subject>Health facilities</subject><subject>Health Impact Assessment</subject><subject>Health services</subject><subject>Humans</subject><subject>Illnesses</subject><subject>Infant</subject><subject>Insurance</subject><subject>Internal customers</subject><subject>Interviews as Topic</subject><subject>Laboratories</subject><subject>Low income groups</subject><subject>Malaria</subject><subject>Malaria - diagnosis</subject><subject>Management</subject><subject>Medical diagnosis</subject><subject>Medical examination</subject><subject>Medical personnel</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Microscopy</subject><subject>Middle Aged</subject><subject>Primary care</subject><subject>Principal components analysis</subject><subject>Rural areas</subject><subject>Rural communities</subject><subject>Rural Population</subject><subject>Surveys and Questionnaires</subject><subject>Vector-borne diseases</subject><subject>Workers</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk12L1DAUhoso7jr6D0QLguhFxzRf094Iw6LrwMqCX7fhNE07GdJkTNrF-femO91lKnshvUiTPOfNOW9ykuRljpY5WeUfdm7wFsxy76xaIkQZY_xRcp6XBGccI_L45P8seRbCDiFGCs6fJmeYIFyikp4nh7WUat9DpY3uD6lrUg97Xae1hta60GuZ9ir0WQVB1WkHFlrVKduP5Fcw4DWk0DnbphK8avWN8mHcG2ytfNbEeSq32tRe2VTb1A8eTHq5jTrPkycNmKBeTOMi-fn504-LL9nV9eXmYn2VSV7iPmOqqinLMWErCWpVlcCgAlbhqqmBgCK4QKyAHCiRuKaoYQyanHPCpap5gckieX3U3RsXxORaEDmhlKFiRVAkNkeidrATe6878AfhQIvbBedbAT46YZRY4aKoqmg_phWVJSoYEKaA5IAbglEZtT5Opw1Vp2oZrYoVz0TnO1ZvRetuxJgOjekskneTgHe_h2i96HSQyhiwyg0xb1Rgiji-rezNP-jD1U1UC7EAbRsXz5WjqFjTssA8PgYeqeUDVPxq1WkZn1ij4_os4P0sIDK9-tO3MIQgNt-__T97_WvOvj1htwpMvw3ODL12NsxBegSldyF41dybnCMxdsidG2LsEDF1SAx7dXpB90F3LUH-Ao7KDAM</recordid><startdate>20120918</startdate><enddate>20120918</enddate><creator>Baiden, Frank</creator><creator>Owusu-Agyei, Seth</creator><creator>Okyere, Eunice</creator><creator>Tivura, Mathilda</creator><creator>Adjei, George</creator><creator>Chandramohan, Daniel</creator><creator>Webster, Jayne</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20120918</creationdate><title>Acceptability of rapid diagnostic test-based management of Malaria among caregivers of under-five children in rural Ghana</title><author>Baiden, Frank ; Owusu-Agyei, Seth ; Okyere, Eunice ; Tivura, Mathilda ; Adjei, George ; Chandramohan, Daniel ; Webster, Jayne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-5ebd4512357cae7b9a5aba5b2bfda3ae328058a1a43c2d40f55af16636ced6823</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Acceptability</topic><topic>Acceptance tests</topic><topic>Adult</topic><topic>Age</topic><topic>Artemisinin</topic><topic>Attitude of Health Personnel</topic><topic>Blood</topic><topic>Care and treatment</topic><topic>Caregivers</topic><topic>Caregivers - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baiden, Frank</au><au>Owusu-Agyei, Seth</au><au>Okyere, Eunice</au><au>Tivura, Mathilda</au><au>Adjei, George</au><au>Chandramohan, Daniel</au><au>Webster, Jayne</au><au>Noor, Abdisalan Mohamed</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acceptability of rapid diagnostic test-based management of Malaria among caregivers of under-five children in rural Ghana</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2012-09-18</date><risdate>2012</risdate><volume>7</volume><issue>9</issue><spage>e45556</spage><epage>e45556</epage><pages>e45556-e45556</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>WHO now recommends test-based management of malaria (TBMM) across all age-groups. This implies artemisinin-based combination treatment (ACT) should be restricted to rapid diagnostic test (RDT)-positive cases. This is a departure from what caregivers in rural communities have been used to for many years.
We conducted a survey among caregivers living close to 32 health centres in six districts in rural Ghana and used logistic regression to explore factors likely to influence caregiver acceptability of RDT based case management and concern about the denial of ACT on account of negative RDT results. Focus group discussions were conducted to explain the quantitative findings and to elicit further factors.
A total of 3047 caregivers were interviewed. Nearly all (98%) reported a preference for TBMM over presumptive treatment. Caregivers who preferred TBMM were less likely to be concerned about the denial of ACT to their test-negative children (O.R. 0.57, 95%C.I. 0.33-0.98). Compared with caregivers who had never secured national health insurance cover, caregivers who had valid (adjusted O.R. 1.30, 95% CI 1.07-1.61) or expired (adjusted O.R. 1.38, 95% CI 1.12-1.73) insurance cover were more likely to be concerned about the denial of ACT to their RDT-negative children. Major factors that promote TBMM acceptability include the perception that a blood test at health centre level represents improvement in the quality of care, leads to improvement in treatment outcomes, and offers opportunity for better communication between health workers and caregivers. Acceptability is also enhanced by engaging caregivers in the procedures of the test. Apprehensions about negative health worker attitude could however undermine acceptance.
Test (RDT)-based management of malaria in under-five children is likely to be acceptable to caregivers in rural Ghana. The quality of caregiver-health worker interaction needs to be improved if acceptability is to be sustained.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23029094</pmid><doi>10.1371/journal.pone.0045556</doi><tpages>e45556</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2012-09, Vol.7 (9), p.e45556-e45556 |
| issn | 1932-6203 1932-6203 |
| language | eng |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acceptability Acceptance tests Adult Age Artemisinin Attitude of Health Personnel Blood Care and treatment Caregivers Caregivers - psychology Child, Preschool Children Diagnosis Diagnostic systems Diagnostic tests Diagnostic Tests, Routine - methods Disease control Ghana Health care facilities Health centres Health facilities Health Impact Assessment Health services Humans Illnesses Infant Insurance Internal customers Interviews as Topic Laboratories Low income groups Malaria Malaria - diagnosis Management Medical diagnosis Medical examination Medical personnel Medical research Medicine Microscopy Middle Aged Primary care Principal components analysis Rural areas Rural communities Rural Population Surveys and Questionnaires Vector-borne diseases Workers Young Adult |
| title | Acceptability of rapid diagnostic test-based management of Malaria among caregivers of under-five children in rural Ghana |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T09%3A21%3A33IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Acceptability%20of%20rapid%20diagnostic%20test-based%20management%20of%20Malaria%20among%20caregivers%20of%20under-five%20children%20in%20rural%20Ghana&rft.jtitle=PloS%20one&rft.au=Baiden,%20Frank&rft.date=2012-09-18&rft.volume=7&rft.issue=9&rft.spage=e45556&rft.epage=e45556&rft.pages=e45556-e45556&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0045556&rft_dat=%3Cgale_plos_%3EA498262306%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1344508730&rft_id=info:pmid/23029094&rft_galeid=A498262306&rft_doaj_id=oai_doaj_org_article_7288bb37124b4c9085a35ea31a2f3209&rfr_iscdi=true |