Quality of Malaria Case Management and Reporting at Public Health Facilities in Six Health Districts in Guinea, 2018

Elizabeth Davlantes Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia;

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Alioune Camara National Malaria Control Program, Conakry, Guinea;

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Timothée Guilavogui National Malaria Control Program, Conakry, Guinea;

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Aissata Fofana StopPalu, RTI International, Conakry, Guinea;

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Mamadou Balde StopPalu, RTI International, Conakry, Guinea;

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Thierno Diallo StopPalu, RTI International, Conakry, Guinea;

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Ibrahima Bah Catholic Relief Services, Conakry, Guinea;

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Lia Florey U.S. President’s Malaria Initiative, Washington, District of Columbia;

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Abdoulaye Sarr Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;
U.S. President’s Malaria Initiative, Centers for Disease Control and Prevention, Conakry, Guinea;

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Jessica Butts Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;
U.S. President’s Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, Georgia

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Mateusz M. Plucinski Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;
U.S. President’s Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, Georgia

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Data on fever and malaria cases reported by health facilities are used for tracking incidence and quantification of malaria commodity needs in Guinea. Periodic assessments of the quality of malaria case management and routine data are a critical activity for the malaria program. In May–June 2018, survey teams visited 126 health facilities in six health districts purposefully selected to represent a spectrum (Stratum 1—high, Stratum 2—intermediate, and Stratum 3—low) of perceived quality of case management and reporting, as assessed from an a priori analysis of routine data. Surveyors performed exit interviews with 939 outpatients and compared results with registry data for interviewed patients. Availability of rapid diagnostic tests (RDTs) and artemisinin-based combination therapies (ACTs) was 100% in Strata 1 and 2, compared with 82% (95% CI: 63–92%) for RDTs and 86% (68–95%) for any formulation of ACT in Stratum 3. Correct case management for suspect malaria cases was 85% in both Stratum 1 (95% CI: 78–90%) and Stratum 2 (79–89%), but only 52% (37–67%) in Stratum 3. Concordance between exit interviews and registry entries for key malaria indicators was significantly higher in Strata 1 and 2 than in Stratum 3. Both adherence to national guidelines for testing and treatment and data quality were high in Strata 1 and 2, but substandard in Stratum 3. The survey results reflected the trends seen in the routine data, suggesting that analysis of routine data can identify areas requiring more attention to improve malaria case management and reporting.

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Author Notes

Address correspondence to Mateusz M. Plucinski, Malaria Branch, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30329. E-mail: mplucinski@cdc.gov

Financial support: The survey was funded by the U.S. President’s Malaria Initiative. J. B. and M. M. P. were supported by the U.S. President’s Malaria Initiative.

Authors’ addresses: Elizabeth Davlantes, Jessica Butts, and Mateusz M. Plucinski, Malaria Branch, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: lyo2@cdc.gov, irg4@cdc.gov, and mplucinski@cdc.gov. Alioune Camara and Timothée Guilavogui, Ministry of Health, National Malaria Control Program, Conakry, Guinea, E-mails: aliounec@gmail.com and gui_timothee@yahoo.fr. Aissata Fofana, Mamadou Balde, and Thierno Diallo, RTI International, Conakry, Guinea, E-mails: afofana@rti.org, mabalde@rti.org, and tbdiallo@rti.org. Ibrahima Bah, Catholic Relief Services, Conakry, Guinea, E-mail: ibrahima.bah@crs.org. Lia Florey, U.S. President’s Malaria Initiative, United States Agency for International Development, Washington, DC, E-mail: lflorey@usaid.gov. Abdoulaye Sarr, Malaria Branch, Centers for Disease Control and Prevention, Conakry, Guinea, E-mail: asarr@usaid.gov.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.

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