Malaria Diagnosis And Treatment Practices In Tolon District, Northern Region

ABSTRACT Introduction: Effective case management involving prompt parasitological diagnosis and treatment with Artemisinin-based Combination Therapy (ACT) has been recognized as the cornerstone of malaria control strategies. Despite Ghana‟s adoption of these recommendations, malaria accounts for 66 % of all OPD cases in Tolon District which is higher than the regional average. This puts doubts in malaria diagnosis and treatment practice. This study therefore sought to assess malaria diagnosis and treatment practices in the Tolon District. Methods: A health facility based cross sectional study was conducted in the Tolon District from December 2014 to May 2015 to assess malaria diagnosis and treatment practices. Direct observation of patient consultations, interviews and record abstraction were employed for data collection. Categorical variables were expressed as proportions and continuous variables were summarized. Logistic regression was used to assess associations between test and treat and the independent variables. Results: The study assessed six health centres, 25 health workers, 175 patient consultations and 420 patient records. Testing rate was 67.1% (278/420). ACT was prescribed to 89.3% of the patients and only 41.0% of suspected malaria patients were diagnosed and treated with ACT. However57.5% (50/87)of patients with negative test results received ACT and 75.9% (104/137) of those who were not tested also received ACT. Compliance to treatment guidelines was found to be associated with type of facility and supervision. Compared to health centres, CHPS has 0.64 times [AOR = 0.64, 95% CI: 0.43-0.95] decreased likely hood of compliance to guidelines and supervised health workers are 2.50 times [AOR = 2.50, 95% CI: 1.15–5.41] more likely to comply with  guidelines. Cadre of health worker, training, years served by health worker and patient age were not significantly associated with compliance to treatment guidelines. Conclusion: Malaria diagnosis and treatment practice in Tolon District is sub optimal. Despite availability of RDT, only 67.1%(282/420) of suspected malaria cases were tested and 89.3% (375/420) of the patients received the first line treatment drug AA and57.5% (50/87) of patients who tested negative for malaria and 75.9% (104/137) of patients not tested for malaria received ACT. Compliance is higher in health centres than in CHPS. Supervision should be intensified especially in the CHPS compounds.