Managing Malaria in the CHPS Compounds in Under Five Children in the Brim Central Municipality of the Eastern Region

Abstract

Background: Malaria remains one of the major public health burdens in Africa in that it is one of the common diagnosis made by prescribers in all out patient departments across the African continent. The infection affects about 3.4 billion people worldwide and accounted for the deaths of 1.2 billion people across the world. The worrying situation about the infection is that of the over-diagnosis of the disease and over prescription of antimalarial to persons who have not been tested for the presence of the parasite before commencing treatment. Objective: The objective of the study was to assess how community health officers manage malaria in children under 5 years at the CHPS compounds and to assess whether the use of malaria RDT has contributed to a reduction in over diagnosis of malaria. Method: A cross sectional study involving simple random sampling method was used to select two or three CHOs from each of the 23 CHPS compounds in the Birim Central Municipality. Data was collected using face to face interview and paper questionnaire. The data was then entered into MS excel 2013 package and transferred into Stata version 15 for analysis. The Pearson’s chi-square and Fishers’ exact tests of association were used to determine the association or relationship between participants’ background characteristics and the level of knowledge on malaria management. The simple and multiple logistic regression models were used to determine the crude and adjusted odds ratio respectively in quantifying the factors that influence participants level of knowledge on malaria management. Results: The mean knowledge score on the scale of 0 to 1 was 0.64 with a standard deviation of 0.11. Also the median score of the overall knowledge of study participants was 0.67 also with an interquartile range of 0.11(thus 0.70 minus 0.59). While 25% of the study participants scored below 0.59, the top 25% of the study participants scored at least 0.70 both on the scale of 0 to 1. With a score of 0.70 as the least threshold of the high knowledge on management of malaria cases, 36.4% (n=24) of the study participants had high knowledge on management of malaria cases with an estimated 95% confidence interval of 24.9% to 49.1%. Conclusion: Testing with malaria RDT before commencing antimalarial treatment was 95.45% from the study. This was higher than the national prevalence rate of RDT testing which stood at 83.9% in 2017. Findings from the study also showed that the use of malaria RDT in managing malaria in the CHPS compounds has drastically reduced the over diagnosis of malaria and the over prescription of antimalarial drugs.