Browsing by Author "Sackey, S.O"

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Evaluation of Notifiable Diseases Surveillance System in Western Area, Sierra Leone, 2014
(University of Ghana, 2014-07) Sowa, D; Sackey, S.O; Nortey, P; University of Ghana, College of Health Sciences, School of Public Health
Background: In Africa, infectious diseases continue to be a major health problem because many of the national surveillance systems have scarce resources at their disposal and struggle to ensure timely detection or an effective response to disease outbreaks. To address this issue, in 1998 the World Health Organization Regional Office for Africa approved the Integrated Disease Surveillance and Response (IDSR) strategy for strengthening infectious disease surveillance and response capacity among its 46 Member States and requested that Member States conduct assessments of their IDSR systems , the findings of which would act as a baseline for reform plans. This study describes the structure, inputs, process and outputs of the notifiable diseases surveillance system in Western Area of Sierra Leone, assesses the knowledge on and practices of disease notification among primary health care providers in the Western Area. Assessing peripheral health units (health facilities) on reporting practices and underreporting of notifiable diseases using cholera as a case study Methods: An evaluation of the surveillance system was done. The study reviewed documents of the disease surveillance system in the Western Area district; reviewed notification data made to the district disease surveillance office by reporting sites. Semi structured questionnaires were used in interviews with communicable diseases coordinators and structured questionnaires were administered by telephone to a random sample of public general practitioners and reporting site staff. Results: The research showed that the notification system in the Western Area District of Sierra Leone is deemed useful by the communicable disease coordinators as it can detect disease outbreaks. However data quality, as indicated by the incompleteness of the "Onset date" of illness reporting on notification, varied between; 33% (n=2) to 81% (n=13). Compliance with disease notification was reported by twelve (12) (75%) of the public general practitioners and the mean score for knowledge on notification status of medical condition was 52%. A total of 258 staff were reported to be present at the sites surveyed; 206 (80%) of them are paid by the government and 52 (20%) of them are not paid by the government. The reporting sites that complied with disease notification were 24 (80%) and the mean score for their knowledge on notification status was 60%. The study revealed that 10 (32%) of all reporting sites have been trained in the Integrated Diseases Surveillance and Response and 12 (38%) reported unavailability of disease manual at sites and all sites lacked trained personnel in data management. In addition 14 (45%) of the sites reported that the surveillance phones given to them for weekly notification reports had developed a fault. Sites asking for monetary incentives due to work load burden were 14 (45%). The unavailability of the notifiable diseases manual was recorded in 12 (38.7%) of the sites surveyed and the remaining 19 (61.2%) had charts on the wall that they could use to assess case definitions but are interested in acquiring the notifiable diseases manual. The shortage of reporting forms within the last six (6) months was reported by 93.5% of the reporting sites especially the tally sheets. Conclusion: The notifiable diseases system is useful and can detect diseases. There are however, many challenges within the system which makes it inefficient at all levels. Even though both the public general practitioners and the site staff self-reported high compliance with notification they cited constraints of high work load and lack of motivation. The knowledge of the notifiable medical condition was lower for the general practitioners than the reporting site staff. The system could perform better with constant refreshers training being implemented at all the levels. The data collected, could also be much better and more meaningful if the system has specialised trained personnel within to analyse the data which in turn could yield more useful results for planning and policy. Keywords: Evaluation, Notifiable Diseases, Surveillance, Western Area, Sierra Leone
Factors Influencing Compliance of Prescribers with Malaria Test-Based Case Management Policy in Effutu Municipality
(University of Ghana, 2014-06) Asamoah, A; Sackey, S.O; University of Ghana, College of Health Sciences, School of Public Health
Introduction: Malaria remains a major public health preventable and treatable mosquito-borne ailment. A test-based case management of malaria and targeted use of Artemisinin-based Combination Therapy (ACT) for treatment has proven to reduce over-diagnosis and overtreatment and therefore recommended as the main control strategy. But compliance by prescribers is still low. Most districts still manage malaria presumptively with treatment of negative test results with ACT. This study was to determine factors that influence the compliance of prescribers with the test-based malaria case management policy in Effutu Municipal. Methods: A cross sectional study was conducted to extract both qualitative and quantitative data from health facility records and prescriber interviews as well as assess prescribers' malaria management of patients. Univariate analyses of categorical variables were expressed as frequencies and proportions. Bivariate analysis was used to show associations between selected independent variables and patient testing as well as treating patients according to test results. Results: Of 175 patients and 25 prescribers assessed for compliance, 125 (71.4%) and 13 (52%) were females respectively. Prescribers complied with the policy for 15 (8.6%) patients suspected of uncomplicated malaria. Factors identified to influence testing included patient age 13 - 45 years OR=1.26(95%CI =0.50-3.20), and measured temperature of ≥37.5oC 2.40(0.66-8.76), patient NHIS status 3.54(0.44-27.99), prescriber age ≤35 years 1.52(0.68-3.42), prescriber female sex 1.74(0.81-3.73), prescriber cadre as physician assistant 2.08(0.79-5.44) and years of experience <6 years 1.71(0.69-4.23), health facility factors such as mission/religious operating authority 5.08(1.67-15.45) and having a functional laboratory or five microscopists. Factors identified to influence treating according to test results included patient age >45 years 1.50(0.17-13.22), and measured temperature of 37.5oC or more 1.23(0.15-9.97), prescriber age ≤35 years 2.15(0.45-10.29), prescriber male sex 2.04(0.51-8.23), prescriber cadre as medical officer and years of experience < 6years 2.17(0.28-25.87), health facility factors such as lower health facility types 6.00(1.33-27.05), government operating authority 8.40(1.27-55.40) having a functional laboratory 1.56(0.13-18.95) and five microscopists 1.22(0.14-10.48). Conclusion: The prescriber compliance with the malaria test-based case management policy in the Effutu Municipal at patient level was low. From this study, prescribers at Mission/Religious operating health facility significantly tested more patients before treatment than those in private hospitals. However, prescribers at government operating health facilities and lower health facility types significantly treated patients according to test results than those in private hospital and hospital facilities respectively. Key words: Malaria, prescribers, compliance, test-based management.