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Readiness of the Kenyan public health sector to provide pre-referral care for severe paediatric malaria.
Amboko, Beatrice; Machini, Beatrice; Githuka, George; Bejon, Philip; Zurovac, Dejan; Snow, Robert W.
  • Amboko B; KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
  • Machini B; Division of National Malaria Programme, Ministry of Health, Nairobi, Kenya.
  • Githuka G; Division of National Malaria Programme, Ministry of Health, Nairobi, Kenya.
  • Bejon P; KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
  • Zurovac D; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
  • Snow RW; KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
Trop Med Int Health ; 27(3): 330-336, 2022 03.
Article in English | MEDLINE | ID: covidwho-1968203
ABSTRACT

OBJECTIVE:

To assess readiness among primary public health facilities in Kenya to provide pre-referral antimalarials for severe malaria.

METHODS:

Nine national surveys of randomly selected primary public health facilities undertaken bi-annually between 2017 and 2021 were analysed. The outcomes included the availability of pre-referral antimalarial drugs at the health facilities and health worker knowledge of recommended pre-referral treatment for severe malaria.

RESULTS:

A total of 1540 health workers from 1355 health facilities were interviewed. Injectable artesunate was available at 46%, injectable quinine at 7%, and artemether at 3% of the health facilities. None of the facilities had rectal artesunate suppositories in stock. A total of 960 (62%) health workers were trained on the use of injectable artesunate. 73% of the health workers who had ever referred a child with severe malaria were aware that artesunate was the recommended treatment, 49% said that intramuscular injection was the preferred route of administration, and 60% stated the correct dose. The overall knowledge level of the treatment policy was low at 21% and only slightly higher among trained than untrained health workers (24% vs 14%; p < 0.001) and those with access to guidelines versus those without access (29% vs 17%; p < 0.001).

CONCLUSIONS:

The readiness of primary health facilities and health workers to deliver appropriate pre-referral care to children with complicated malaria in Kenya is inadequate. Further investments are required to ensure (a) availability of nationally recommended pre-referral antimalarials; (b) appropriate training and supervision in their administration, and (c) monitoring of the entire referral process.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Malaria / Antimalarials Type of study: Experimental Studies / Observational study / Randomized controlled trials Limits: Child / Humans Country/Region as subject: Africa Language: English Journal: Trop Med Int Health Journal subject: Tropical Medicine / Public Health Year: 2022 Document Type: Article Affiliation country: Tmi.13728

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Malaria / Antimalarials Type of study: Experimental Studies / Observational study / Randomized controlled trials Limits: Child / Humans Country/Region as subject: Africa Language: English Journal: Trop Med Int Health Journal subject: Tropical Medicine / Public Health Year: 2022 Document Type: Article Affiliation country: Tmi.13728