Abstract:
Introduction: Severe malaria is a medical emergency that requires appropriate management to prevent death. Effective case management of severe malaria is expensive and requires appropriate clinical assessment, laboratory proof of the disease prior to treatment with an effective antimalarial. Despite Ghana’s adoption of treatment with Artemisinin based Combination Therapy (ACT), the mortality of children due to severe malaria still remains unacceptably high especially in the Northern part of the country. This study sought to assess the case management of severe malaria in the Tamale Metropolis.
Methods: The study employed a descriptive cross-sectional approach to assess severe malaria case management practices. Both qualitative and quantitative data were extracted from health facility records of admitted patients, health workers involved in malaria case management and patient/caregivers of children. Data were presented as frequencies and proportions. Bivariate analysis was performed to identify the associations between selected independent variables and appropriate malaria case management.
Result: Of the 404 health facility record reviewed, 225 (55.7%) were males. Temperature and weight were checked for 97.0% and 98.8% of patients. About 298 (73.7%) were tested for parasitemia either by microscopy or rapid diagnostic test but only 99 (33.2%) were positive for malaria. All the cases were treated with antimalarial whether tested positive or negative for malaria parasite. About 71.3% of patient were treated with IV Artesunate and 46% with Arthemeter lumefantrine as first and second line of treatment. Quality assurance system was not in place in all the health facilities. About 44.3% (27/61) of the health worker have had training on integrated management of childhood illness. Drugs were purchased by 45% (18/40) patients and medical supplies by 60% (24/40) (patients. Age and fever were associated with conformity with the standard treatment guideline.
Conclusion: Case management of severe malaria in the Tamale metropolis was sub-optimal. There were several disregards for negative diagnostic test as well as inappropriate treatment practices. Significant improvement is needed in the area of appropriate diagnosis and treatment, quality assurance system, training and supervision and availability of drugs and supplies.
