ASSESSING THE IMPLEMENTATION OF THE TEST, TREAT AND TRACK STRATEGY FOR MALARIA DIAGNOSIS AND MANAGEMENT IN THE ATEBUBU-AMANTIN DISTRICT

ABSTRACT

Background: The World Health Organization places emphasis on the test and confirm any suspected malaria case either by microscopy or by rapid diagnostic test before treatment with ACT. Almost half of all suspected malaria cases in endemic countries in Africa are still being treated presumptively. This study assessed prescribers’ compliance to the Test, Treat and Track (T3) strategy for diagnosing and managing uncomplicated malaria.

Methods: Out Patients Department records covering the period 2012 to 2016 at the Atebubu Government Hospital were reviewed in 2017 to determine the proportion of fever cases that were tested for malaria before Artemisinin-based Combination Therapy (ACT) was prescribed and whether cases that tested negative were prescribed antimalarial medicine (ACT). A data capturing form was developed and used to capture data on hospital attendants (all cases) of suspected malaria cases that were referred to the laboratory for testing before treatment was given. The tool also captured the number of cases that tested negative and yet were prescribed antimalarial medicine.

Results: Out of the 385 fever cases that were reviewed, 72.8% was tested, out of which 42.9% was confirmed malaria (positive). All the confirmed cases (42.9%) were treated with ACT, whilst 10.1% of cases that tested negative were also treated with ACT. Also, 40.4% were not asked to return for review.

Conclusions: Compliance with the test of fever cases by prescribers was poor as 29.3% of them were not tested for malaria and yet were diagnosed as malaria and treated with ACTs. A proportion (10.1%) of the fever cases that tested negative were presumptively treated with ACT as malaria. Also compliance to the treatment guidelines of ACT for malaria and requesting for patients who were treated to return for review was poor, so the tracking component of the T3 strategy still remains a challenge. The Ministry of Health and the Ghana Health Service should ensure regular supervision and sensitization of prescribers on the relevance of the T3 strategy.