ABSTRACT
Objective@#To investigate the current status of malaria rapid diagnostic test (RDT) strips application and malaria laboratory technicians' evaluation about them at primary healthcare provider level in Jiangsu Province.@*Methods@#From November to December 2016, 878 medical institutions and 118 CDCs of city, county and township/community level in Jiangsu Province were selected as study samples using stratified random sampling method. Self-designed questionnaire was distributed to investigate the institution's malaria work task, RDT strips application and evaluation status in 2015. We also investigated the socio-demographic information and collected the RDT strips evaluation score from the malaria laboratory technicians selected from the institutions investigated (one technician from each institution). Rank sum test was performed to compare the RDT strips evaluation scores between medical institutions and CDCs, and among different medical institutions and CDCs.@*Results@#In 2015, 405 cases of malaria were reported, 362 200 person-time of malaria blood testing task was conducted, and 100 000 RDT strips were procured and provided for healthcare providers in Jiangsu province for free. Of the 996 healthcare institutions investigated, 628 used RDT strips in the year 2015 and the median (P25, P75) of RDT strips volume used in these institutions was 10 (2, 25). The volume of RDT strips used in CDCs (15 (5, 52)) was significantly higher than that in medical institutions (10 (2, 25), (Z=3.42, P=0.001)). The investigated CDCs gave higher score on RDT strips' testing time per operation (10 (8.5, 10)) than medical institutions (9(8, 10), (Z=-2.20, P=0.028)). The employers of 614 investigated malaria laboratory technicians used RDT strips in 2015. The median of the scores given by CDC malaria laboratory technicians for RDT strips in terms of testing time per operation, testing operation and results judgement difficulties were 10 (9, 10), 10 (9, 10) and 10 (9, 10), respectively, which were significantly higher than those from technicians of medical institutions (9 (8, 10), 9 (8, 10), 9 (8, 10), (Z values were -2.55, -2.97 and -2.96, respectively; P values were all less than 0.05)).@*Conclusion@#RDT strips had been widely performed in health institutions in Jiangsu Province. The amount of RDT strips used in CDCs was significantly higher than that in medical institutions. Primary-level institutions and malaria laboratory technicians generally recognized RDT strips' advantage for application in terms of testing time and operational procedure. CDCs and malaria laboratory technicians from them gave higher regards on RDT strips in terms of testing time per operation, testing operation and results judgement difficulties compared with that of medical institutions.
ABSTRACT
Aims: In much of Africa, Ghana inclusive, malaria has traditionally been diagnosed and treated presumptively: any patient with fever was presumed to have malaria and treated with antimalarial drugs. In this study, the retail pharmacies practitioners’ perspectives on the implementation of Malaria Rapid Diagnostic Tests was sought and decisions analyzed in themes, using Realist Conceptual Approach. Study Design: Cross-sectional quantitative and purposive study. Place and Duration of Study: Registered private pharmacies in Ashanti Region of Ghana, between September and November, 2013. Methodology: A structured pre-tested questionnaires (in non-study area) was selfadministered to 99 practitioners in retail pharmacies to generated information on Practitioner’s characteristics, knowledge and experience on the MRDT kits, acceptance and willingness to use the test kits and challenge towards the use of the kit, for the thematic analysis. Results: Practitioners within the age bracket of 30-40 years were highest (43%) and male representation was 67%. Pharmacists were 67% of practitioners and 17.1% had postgraduate qualification. 96.03% had ample knowledge of test kit and 0.99% use it always and logistic regression indicated no significance (Chi-square=0.751; LR=0.540 at p<0.05). Of the patients, 47.52% strongly agree to implement and 48.51 agree. 60.39% were definite to suggest to colleague and logistic regression indicated significant relation (Chi-square=0.000; LR=0.006 at p<0.05). 44.4% were very satisfied with presumptive diagnosis while 1% very dissatisfied. Conclusion: The findings indicated willingness to implement the policy but presumptive diagnosis is still the practice. The evidence provides an opportunity to adapt a conceptual framework leading to the uptake of the policy.