ArticleMalaria journal2014
Management of febrile children under five years in hospitals and health centres of rural Ghana.
Article in Malaria journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 17 citations in OpenAlex.
- Health Worker Compliance with a 'Test And Treat' Malaria Case Management Protocol in Papua New Guinea.PloS one · 2016Trial
- How, why, and under what circumstances can supportive supervision programs improve malaria case management? A realist program theory.Health policy and planning · 2025Article
- Health literacy and household financial loss on malaria treatment for children under five in Ghana: a patients' perspective.International health · 2025Article
- The Effect of Mass Testing, Treatment and Tracking on the Prevalence of Febrile Illness in Children under 15 in Ghana.Pathogens (Basel, Switzerland) · 2022Article
- Socio-cultural barriers to the delivery and utilisation of child healthcare services in rural Ghana: a qualitative study.BMC health services research · 2022Article
- Trends in health workers' compliance with outpatient malaria case-management guidelines across malaria epidemiological zones in Kenya, 2010-2016.Malaria journal · 2020Article
- A qualitative appraisal of stakeholders' perspectives of a community-based primary health care program in rural Ghana.BMC health services research · 2019Article
- Quality of malaria services offered in public health facilities in three provinces of Mozambique: a cross-sectional study.Malaria journal · 2019Article
- Demand-related factors influencing caregivers' awareness of malaria tests and health workers' testing practices, in Makarfi, Nigeria.Malaria journal · 2017Article
- Clinical management of children with fever: a cross-sectional study of quality of care in rural Zambia.Bulletin of the World Health Organization · 2017Article
- Quality of Health Care in Ghana: Mapping of Interventions and the Way Forward.Ghana medical journal · 2016Article
- Examining Intervention Design: Lessons from the Development of Eight Related Malaria Health Care Intervention Studies.Health systems and reform · 2016Article
- Implementation of the integrated management of childhood illness with parasitological diagnosis of malaria in rural Ghana: health worker perceptions.Malaria journal · 2015Article
- Effective coverage and systems effectiveness for malaria case management in sub-Saharan African countries.PloS one · 2015Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe case management of febrile children in hospitals' and health centres' pre-roll out of the new WHO policy on parasitological diagnosis was assessed. The delivery of artemisinin combination therapy (ACT) at these two levels of the health system was compared.
methodsStructured observations and exit interviews of 1,222 febrile children attending five hospitals and 861 attending ten health centres were conducted in six districts of the Brong Ahafo Region of Ghana. Effectiveness of delivery of case management of malaria was assessed. Proportions of children receiving ACT, anti-malarial monotherapy and antibiotics were described. Predictors of: a febrile child being given an ACT, a febrile child being given an antibiotic and of carers knowing how to correctly administer the ACT were assessed using logistic regression models stratified by hospitals and health centres.
resultsThe system's effectiveness of delivering an ACT to febrile children diagnosed with malaria (parasitologically or clinically) was 31.4 and 42.4% in hospitals and health centres, respectively. The most ineffective process was that of ensuring that carers knew how to correctly administer the ACT. Overall 278 children who were not given an ACT were treated with anti-malarial monotherapy other than quinine. The majority of these children, 232/278 were given amodiaquine, 139 of these were children attending hospitals and 93 attending health centres. The cadre of health staff conducting consultation was a common predictor of the outcomes of interest. Presenting symptoms and examinations conducted were predictive of being given an ACT in hospitals and antibiotic in hospitals and health centres but not of being given an ACT in health centres. Treatment-seeking factors were predictive of being given an ACT if it was more than seven days since the fever began and an antibiotic in hospitals but not in health centres.
conclusionInterventions to improve adherence to negative parasitological tests are needed, together with guidance on dispensing of antibiotics, but improving the education of carers on how to administer ACT will lead to the greatest immediate increase in the effectiveness of case management. Guidance is needed on implementation of the new test-based treatment for malaria policy in health facilities.
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