ArticleMalaria journal2021
Do clinicians in areas of declining malaria transmission adhere to malaria diagnosis guidelines? A cross-sectional study from Kampala, Uganda.
Article in Malaria journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 8 citations in OpenAlex.
- Ensemble Machine Learning for Malaria Diagnosis in Resource-Limited Settings Using Clinical and Demographic Features.Infectious disease reports · 2026Article
- Facilitators and barriers to adherence to severe malaria treatment guidelines in children at Mbale Regional Referral Hospital, Uganda: a health workers' perspective.Malaria journal · 2026Article
- Strengthening anthrax outbreak response and preparedness: simulation and stakeholder education in Namisindwa district, Uganda.BMC veterinary research · 2024Article
- Malaria diagnostic and treatment practices for febrile children under 5 years at two general hospitals in Karamoja, a high transmission setting in Uganda.Malaria journal · 2022Article
- Adherence to malaria management guidelines by health care workers in the Busoga sub-region, eastern Uganda.Malaria journal · 2022Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundUganda's clinical management guidelines recommend a malaria laboratory test in all patients presenting with fever (history of fever or an axillary temperature ≥ 37.5 °C), and only those with a positive test receive anti-malarial treatment. However, the current practice in areas with declining malaria transmission remains unknown. This study assessed the clinicians' diagnostic practices, the factors associated with recommending a test, and the risk of missing a malaria case when a test is not recommended in patients presenting with fever in Kampala, an area of declining malaria transmission in Uganda.
methodsBetween January and March 2020, 383 participants aged ≥ 12 years and presenting to Kisenyi Health Centre IV in Kampala district with fever were enrolled in the study. A questionnaire was administered during exit interviews, routine diagnostic practices were recorded from participant clinical notes, and a research blood slide was obtained for later reading.
resultsOf the enrolled participants, 356 (93%) had a malaria diagnostic test recommended by the clinician. Factors associated with increasing prevalence of having a test recommended included; history of overnight travel (adjusted prevalence ratio [aPR] 1.07, 95% confidence interval [CI] 1.02-1.13, p = 0.011), being married (aPR = 1.07, 95% CI 1.01-1.13, p = 0.022), and having tertiary education (aPR = 1.09 95% CI 1.01-1.17, p = 0.031). Among the 27 participants where a malaria diagnostic test was not recommended, 4 (14.8%) had a positive study smear.
conclusionDespite having significant declines in malaria transmission in Kampala in the last decade, clinicians at the study health facility highly adhered to the clinical management guidelines, recommending a malaria test in almost all patients presenting with fever. However, a significant proportion of malaria cases was missed when a test was not recommended. These results highlight the importance of laboratory testing for malaria in all patients who present with fevers and live in endemic settings even when the transmission has significantly declined.
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