Failures in the case management of children with uncomplicated malaria in Bata district of Equatorial Guinea and associated factors
In Equatorial Guinea, malaria continues to be one of the main causes of morbidity and mortality among children. The National Therapeutic Guide established artesunate-amodiaquine (ASAQ) as first-line treatment for uncomplicated malaria, but compliance with this treatment is low. The aim of this study...
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| creator | Suárez-Sánchez, Pablo García, Belén Nzang, Jesús Ncogo, Policarpo Riloha, Matilde Berzosa, Pedro Benito, Agustín Romay-Barja, María |
| description | In Equatorial Guinea, malaria continues to be one of the main causes of morbidity and mortality among children. The National Therapeutic Guide established artesunate-amodiaquine (ASAQ) as first-line treatment for uncomplicated malaria, but compliance with this treatment is low. The aim of this study was to assess, for the first time, the performance of public healthcare workers in the diagnosis and treatment of uncomplicated malaria, their compliance with first-line Malaria National Therapeutic Guide and the associated factors.
A cross-sectional survey was conducted at the nine public health facilities in the Bata District of Equatorial Guinea to assess the management of uncomplicated malaria in children < 15 years of age. Bivariate and multivariate statistical analyses were used to determine the recommended treatment compliance and related factors.
A total of 227 children with uncomplicated malaria were recorded from 9 public health facilities. Most of the treatments prescribed (83.3%) did not follow the first-line treatment recommended for uncomplicated malaria. The diagnosis was established with parasite confirmation in 182 cases (80.2%). After adjustment for other variables, children under 2 months of age, the use of parasite confirmation to the diagnosis of malaria and being familiar with the national therapeutic guide were significantly associated with the prescription of the first-line recommended treatment. Cases attended at the hospital or in a health facility with ASAQ in the pharmacy at the time of the study were also more likely to be prescribed with the recommended treatment, but with non-significant association after adjustment for other variables.
This study identified the factors associated with the low compliance with the first-line treatment by the public healthcare facilities of Bata District of Equatorial Guinea. It seems necessary to improve case management of children with uncomplicated malaria; to reinforce the use of Malaria National Therapeutic Guide and to inform about the danger of using artemisinin monotherapy. Furthermore, it is crucial to provide recommended first-line treatment to the pharmacies of all public health facilities to ensure access to this treatment. |
| doi_str_mv | 10.1371/journal.pone.0220789 |
| format | Article |
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A cross-sectional survey was conducted at the nine public health facilities in the Bata District of Equatorial Guinea to assess the management of uncomplicated malaria in children < 15 years of age. Bivariate and multivariate statistical analyses were used to determine the recommended treatment compliance and related factors.
A total of 227 children with uncomplicated malaria were recorded from 9 public health facilities. Most of the treatments prescribed (83.3%) did not follow the first-line treatment recommended for uncomplicated malaria. The diagnosis was established with parasite confirmation in 182 cases (80.2%). After adjustment for other variables, children under 2 months of age, the use of parasite confirmation to the diagnosis of malaria and being familiar with the national therapeutic guide were significantly associated with the prescription of the first-line recommended treatment. Cases attended at the hospital or in a health facility with ASAQ in the pharmacy at the time of the study were also more likely to be prescribed with the recommended treatment, but with non-significant association after adjustment for other variables.
This study identified the factors associated with the low compliance with the first-line treatment by the public healthcare facilities of Bata District of Equatorial Guinea. It seems necessary to improve case management of children with uncomplicated malaria; to reinforce the use of Malaria National Therapeutic Guide and to inform about the danger of using artemisinin monotherapy. Furthermore, it is crucial to provide recommended first-line treatment to the pharmacies of all public health facilities to ensure access to this treatment.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0220789</identifier><identifier>PMID: 31374107</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Amodiaquine ; Amodiaquine - therapeutic use ; Antimalarials - therapeutic use ; Artemisinin ; Artemisinins - therapeutic use ; Artesunate ; Biology and Life Sciences ; Bivariate analysis ; Care and treatment ; Case Management ; Child ; Child, Preschool ; Children ; Compliance ; Cross-Sectional Studies ; Diagnosis ; Drug Combinations ; Drugs ; Drugstores ; Employee performance ; Equatorial Guinea ; Guideline Adherence ; Hazards ; Health care ; Health care facilities ; Health care reform ; Health Care Surveys ; Health Facilities ; Hospital facilities ; Humans ; Infant ; Infant, Newborn ; Malaria ; Malaria - diagnosis ; Malaria - drug therapy ; Management ; Medical case management ; Medical diagnosis ; Medical personnel ; Medicine and Health Sciences ; Morbidity ; Mortality ; Mutation ; Parasites ; Patient compliance ; People and places ; Pharmacy ; Public health ; Pyrimethamine ; Statistical analysis ; Urban areas ; Vector-borne diseases ; Workers</subject><ispartof>PloS one, 2019-08, Vol.14 (8), p.e0220789-e0220789</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Suárez-Sánchez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://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>2019 Suárez-Sánchez et al 2019 Suárez-Sánchez et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-737404a4f287b63bf9bf03f5689820504fbc196729a14b54f7d3b041c08df9b53</citedby><cites>FETCH-LOGICAL-c692t-737404a4f287b63bf9bf03f5689820504fbc196729a14b54f7d3b041c08df9b53</cites><orcidid>0000-0001-7617-6799 ; 0000-0002-0177-6885</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6677319/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6677319/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31374107$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Smith, Thomas A.</contributor><creatorcontrib>Suárez-Sánchez, Pablo</creatorcontrib><creatorcontrib>García, Belén</creatorcontrib><creatorcontrib>Nzang, Jesús</creatorcontrib><creatorcontrib>Ncogo, Policarpo</creatorcontrib><creatorcontrib>Riloha, Matilde</creatorcontrib><creatorcontrib>Berzosa, Pedro</creatorcontrib><creatorcontrib>Benito, Agustín</creatorcontrib><creatorcontrib>Romay-Barja, María</creatorcontrib><title>Failures in the case management of children with uncomplicated malaria in Bata district of Equatorial Guinea and associated factors</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>In Equatorial Guinea, malaria continues to be one of the main causes of morbidity and mortality among children. The National Therapeutic Guide established artesunate-amodiaquine (ASAQ) as first-line treatment for uncomplicated malaria, but compliance with this treatment is low. The aim of this study was to assess, for the first time, the performance of public healthcare workers in the diagnosis and treatment of uncomplicated malaria, their compliance with first-line Malaria National Therapeutic Guide and the associated factors.
A cross-sectional survey was conducted at the nine public health facilities in the Bata District of Equatorial Guinea to assess the management of uncomplicated malaria in children < 15 years of age. Bivariate and multivariate statistical analyses were used to determine the recommended treatment compliance and related factors.
A total of 227 children with uncomplicated malaria were recorded from 9 public health facilities. Most of the treatments prescribed (83.3%) did not follow the first-line treatment recommended for uncomplicated malaria. The diagnosis was established with parasite confirmation in 182 cases (80.2%). After adjustment for other variables, children under 2 months of age, the use of parasite confirmation to the diagnosis of malaria and being familiar with the national therapeutic guide were significantly associated with the prescription of the first-line recommended treatment. Cases attended at the hospital or in a health facility with ASAQ in the pharmacy at the time of the study were also more likely to be prescribed with the recommended treatment, but with non-significant association after adjustment for other variables.
This study identified the factors associated with the low compliance with the first-line treatment by the public healthcare facilities of Bata District of Equatorial Guinea. It seems necessary to improve case management of children with uncomplicated malaria; to reinforce the use of Malaria National Therapeutic Guide and to inform about the danger of using artemisinin monotherapy. Furthermore, it is crucial to provide recommended first-line treatment to the pharmacies of all public health facilities to ensure access to this treatment.</description><subject>Adolescent</subject><subject>Amodiaquine</subject><subject>Amodiaquine - therapeutic use</subject><subject>Antimalarials - therapeutic use</subject><subject>Artemisinin</subject><subject>Artemisinins - therapeutic use</subject><subject>Artesunate</subject><subject>Biology and Life Sciences</subject><subject>Bivariate analysis</subject><subject>Care and treatment</subject><subject>Case Management</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Compliance</subject><subject>Cross-Sectional Studies</subject><subject>Diagnosis</subject><subject>Drug Combinations</subject><subject>Drugs</subject><subject>Drugstores</subject><subject>Employee performance</subject><subject>Equatorial Guinea</subject><subject>Guideline Adherence</subject><subject>Hazards</subject><subject>Health care</subject><subject>Health care facilities</subject><subject>Health care reform</subject><subject>Health Care Surveys</subject><subject>Health Facilities</subject><subject>Hospital facilities</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Malaria</subject><subject>Malaria - diagnosis</subject><subject>Malaria - drug therapy</subject><subject>Management</subject><subject>Medical case management</subject><subject>Medical diagnosis</subject><subject>Medical personnel</subject><subject>Medicine and Health Sciences</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Mutation</subject><subject>Parasites</subject><subject>Patient compliance</subject><subject>People and places</subject><subject>Pharmacy</subject><subject>Public health</subject><subject>Pyrimethamine</subject><subject>Statistical analysis</subject><subject>Urban areas</subject><subject>Vector-borne diseases</subject><subject>Workers</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</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>eNqNk8tu3CAUhq2qVZNO-wZVi1SpahczBWNjexMpjZJ0pEiRetuiYwxjIgwTwL2s--JlLonGVRYVCxDn-3_gHE6WvSR4QWhFPty40Vswi7WzcoHzHFd18yg7Jg3N5yzH9PHB-ih7FsINxiWtGXuaHdHkUBBcHWd_LkCb0cuAtEWxl0hAkGgACys5SBuRU0j02nReWvRTxx6NVrhhbbSAKLtEGvAaNuqPEAF1OkSvxVZ3fjtCdClq0OWorQQEtkMQghN6K1YgUjw8z54oMEG-2M-z7NvF-dezT_Or68vl2enVXLAmj_Mq3RkXUKi8rlpGW9W0ClNVsrqpc1ziQrWCNKzKGyBFWxaq6miLCyJw3SW2pLPs9c53bVzg-_wFnuesxg1tME3Eckd0Dm742usB_G_uQPPthvMrDj5qYSSHqsKCgSKKkiIvAIpaYSZqBaxrSdclr5P9aWM7yE6kZHowE9NpxOqer9wPzlhV0VS6WfZub-Dd7ShD5IMOQhoDVrpxd2-K6ybVd5a9-Qd9-HV7agXpAdoql84VG1N-WjYlJTXBeaIWD1BpdHLQIn02pdP-RPB-IkhMlL_iCsYQ-PLL5_9nr79P2bcHbC_BxD44M0btbJiCxQ4U3oXgpbpPMsF80yt32eCbXuH7XkmyV4cFuhfdNQf9C5T7D4c</recordid><startdate>20190802</startdate><enddate>20190802</enddate><creator>Suárez-Sánchez, Pablo</creator><creator>García, Belén</creator><creator>Nzang, Jesús</creator><creator>Ncogo, Policarpo</creator><creator>Riloha, Matilde</creator><creator>Berzosa, Pedro</creator><creator>Benito, Agustín</creator><creator>Romay-Barja, María</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>AEUYN</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><orcidid>https://orcid.org/0000-0001-7617-6799</orcidid><orcidid>https://orcid.org/0000-0002-0177-6885</orcidid></search><sort><creationdate>20190802</creationdate><title>Failures in the case management of children with uncomplicated malaria in Bata district of Equatorial Guinea and associated factors</title><author>Suárez-Sánchez, Pablo ; García, Belén ; Nzang, Jesús ; Ncogo, Policarpo ; Riloha, Matilde ; Berzosa, Pedro ; Benito, Agustín ; Romay-Barja, María</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-737404a4f287b63bf9bf03f5689820504fbc196729a14b54f7d3b041c08df9b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Amodiaquine</topic><topic>Amodiaquine - therapeutic use</topic><topic>Antimalarials - therapeutic use</topic><topic>Artemisinin</topic><topic>Artemisinins - therapeutic use</topic><topic>Artesunate</topic><topic>Biology and Life Sciences</topic><topic>Bivariate analysis</topic><topic>Care and treatment</topic><topic>Case Management</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Compliance</topic><topic>Cross-Sectional Studies</topic><topic>Diagnosis</topic><topic>Drug Combinations</topic><topic>Drugs</topic><topic>Drugstores</topic><topic>Employee performance</topic><topic>Equatorial Guinea</topic><topic>Guideline Adherence</topic><topic>Hazards</topic><topic>Health care</topic><topic>Health care facilities</topic><topic>Health care reform</topic><topic>Health Care Surveys</topic><topic>Health Facilities</topic><topic>Hospital facilities</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Malaria</topic><topic>Malaria - diagnosis</topic><topic>Malaria - 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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>Suárez-Sánchez, Pablo</au><au>García, Belén</au><au>Nzang, Jesús</au><au>Ncogo, Policarpo</au><au>Riloha, Matilde</au><au>Berzosa, Pedro</au><au>Benito, Agustín</au><au>Romay-Barja, María</au><au>Smith, Thomas A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Failures in the case management of children with uncomplicated malaria in Bata district of Equatorial Guinea and associated factors</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-08-02</date><risdate>2019</risdate><volume>14</volume><issue>8</issue><spage>e0220789</spage><epage>e0220789</epage><pages>e0220789-e0220789</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>In Equatorial Guinea, malaria continues to be one of the main causes of morbidity and mortality among children. The National Therapeutic Guide established artesunate-amodiaquine (ASAQ) as first-line treatment for uncomplicated malaria, but compliance with this treatment is low. The aim of this study was to assess, for the first time, the performance of public healthcare workers in the diagnosis and treatment of uncomplicated malaria, their compliance with first-line Malaria National Therapeutic Guide and the associated factors.
A cross-sectional survey was conducted at the nine public health facilities in the Bata District of Equatorial Guinea to assess the management of uncomplicated malaria in children < 15 years of age. Bivariate and multivariate statistical analyses were used to determine the recommended treatment compliance and related factors.
A total of 227 children with uncomplicated malaria were recorded from 9 public health facilities. Most of the treatments prescribed (83.3%) did not follow the first-line treatment recommended for uncomplicated malaria. The diagnosis was established with parasite confirmation in 182 cases (80.2%). After adjustment for other variables, children under 2 months of age, the use of parasite confirmation to the diagnosis of malaria and being familiar with the national therapeutic guide were significantly associated with the prescription of the first-line recommended treatment. Cases attended at the hospital or in a health facility with ASAQ in the pharmacy at the time of the study were also more likely to be prescribed with the recommended treatment, but with non-significant association after adjustment for other variables.
This study identified the factors associated with the low compliance with the first-line treatment by the public healthcare facilities of Bata District of Equatorial Guinea. It seems necessary to improve case management of children with uncomplicated malaria; to reinforce the use of Malaria National Therapeutic Guide and to inform about the danger of using artemisinin monotherapy. Furthermore, it is crucial to provide recommended first-line treatment to the pharmacies of all public health facilities to ensure access to this treatment.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31374107</pmid><doi>10.1371/journal.pone.0220789</doi><tpages>e0220789</tpages><orcidid>https://orcid.org/0000-0001-7617-6799</orcidid><orcidid>https://orcid.org/0000-0002-0177-6885</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-08, Vol.14 (8), p.e0220789-e0220789 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2268093903 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Amodiaquine Amodiaquine - therapeutic use Antimalarials - therapeutic use Artemisinin Artemisinins - therapeutic use Artesunate Biology and Life Sciences Bivariate analysis Care and treatment Case Management Child Child, Preschool Children Compliance Cross-Sectional Studies Diagnosis Drug Combinations Drugs Drugstores Employee performance Equatorial Guinea Guideline Adherence Hazards Health care Health care facilities Health care reform Health Care Surveys Health Facilities Hospital facilities Humans Infant Infant, Newborn Malaria Malaria - diagnosis Malaria - drug therapy Management Medical case management Medical diagnosis Medical personnel Medicine and Health Sciences Morbidity Mortality Mutation Parasites Patient compliance People and places Pharmacy Public health Pyrimethamine Statistical analysis Urban areas Vector-borne diseases Workers |
| title | Failures in the case management of children with uncomplicated malaria in Bata district of Equatorial Guinea and associated factors |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-18T12%3A50%3A52IST&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=Failures%20in%20the%20case%20management%20of%20children%20with%20uncomplicated%20malaria%20in%20Bata%20district%20of%20Equatorial%20Guinea%20and%20associated%20factors&rft.jtitle=PloS%20one&rft.au=Su%C3%A1rez-S%C3%A1nchez,%20Pablo&rft.date=2019-08-02&rft.volume=14&rft.issue=8&rft.spage=e0220789&rft.epage=e0220789&rft.pages=e0220789-e0220789&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0220789&rft_dat=%3Cgale_plos_%3EA595318102%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=2268093903&rft_id=info:pmid/31374107&rft_galeid=A595318102&rft_doaj_id=oai_doaj_org_article_a770c6af1f31424aa48f06c8fa6db1dd&rfr_iscdi=true |