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.

  • 1.

    Guilavogui T, Koivogui A, Camara A, Delamou D, Diallo AS, Lo Y, 2018. The challenge of rapid management of fever in children under 5 in Guinea. Epidemiol Infect 146: 19871995.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Guinea National Statistics Institute (INS), National Malaria Control Program (PNLP) and ICF, 2016. Multiple Indicator Cluster Survey. Rockville, MD: INS, PNLP and ICF.

    • PubMed
    • Export Citation
  • 3.

    Guinea National Statistics Institute (INS) and ICF, 2012. Demographic Health Survey. Rockville, MD: INS and ICF.

    • PubMed
    • Export Citation
  • 4.

    Guinea National Malaria Control Program, 2017. Malaria Strategic Plan 2018–2022. Conakry, Guinea: Guinea Ministry of Health.

  • 5.

    President’s Malaria Initiative, 2018. Guinea Malaria Operational Plan FY 2018. Washington, DC: President’s Malaria Initiative.

  • 6.

    Guinea National Malaria Control Program, 2014. National Malaria Policy. Conakry, Guinea: Guinea Ministry of Health.

  • 7.

    Plucinski MM, Guilavogui T, Camara A, Ndiop M, Cisse M, Painter J, Thwing J, 2018. How far are we from reaching universal malaria testing of all fever cases? Am J Trop Med Hyg 99: 670679.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Githinji S, Noor AM, Malinga J, Macharia PM, Kiptui R, Omar A, Njagi K, Waqo E, Snow RW, 2016. A national health facility survey of malaria infection among febrile patients in Kenya, 2014. Malar J 15: 591.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Plucinski MM et al. 2017. Evaluating malaria case management at public health facilities in two provinces in Angola. Malar J 16: 186.

  • 10.

    Landman KZ, Jean SE, Existe A, Akom EE, Chang MA, Lemoine JF, Mace KE, 2015. Evaluation of case management of uncomplicated malaria in Haiti: a national health facility survey, 2012. Malar J 14: 394.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Steinhardt LC, Chinkhumba J, Wolkon A, Luka M, Luhanga M, Sande J, Oyugi J, Ali D, Mathanga D, Skarbinski J, 2014. Quality of malaria case management in Malawi: results from a nationally representative health facility survey. PLoS One 9: e89050.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Plucinski MM et al. 2015. Effect of the Ebola-virus-disease epidemic on malaria case management in Guinea, 2014: a cross-sectional survey of health facilities. Lancet Infect Dis 15: 10171023.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Hennessee I, Guilavogui T, Camara A, Halsey ES, Marston B, McFarland D, Freeman M, Plucinski MM, 2018. Adherence to Ebola-specific malaria case management guidelines at health facilities in Guinea during the West African Ebola epidemic. Malar J 17: 230.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    World Health Organization, 2015. Service Availability and Readiness Assessment: An Annual Monitoring System for Service Delivery. Geneva, Switzerland: WHO.

  • 15.

    Vyas S, Kumaranayake L, 2006. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan 21: 459468.

  • 16.

    Lumley T, 2004. Analysis of complex survey samples. J Stat Softw 9.

  • 17.

    Bilal JA, Gasim GI, Abdien MT, Elmardi KA, Malik EM, Adam I, 2015. Poor adherence to the malaria management protocol among health workers attending under-five year old febrile children at Omdurman Hospital, Sudan. Malar J 14: 34.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Zurovac D, Githinji S, Memusi D, Kigen S, Machini B, Muturi A, Otieno G, Snow RW, Nyandigisi A, 2014. Major improvements in the quality of malaria case-management under the “test and treat” policy in Kenya. PLoS One 9: e92782.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Millar KR, McCutcheon J, Coakley EH, Brieger W, Ibrahim MA, Mohammed Z, Bassi A, Sambisa W, 2014. Patterns and predictors of malaria care-seeking, diagnostic testing, and artemisinin-based combination therapy for children under five with fever in Northern Nigeria: a cross-sectional study. Malar J 13: 447.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Camara A et al. 2019. Prescriber practices and patient adherence to artemisinin-based combination therapy for the treatment of uncomplicated malaria in Guinea, 2016. Malar J 18: 23.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Riley C, Dellicour S, Ouma P, Kioko U, Omar A, Kariuki S, Desai M, Buff AM, Gutman JR, 2016. Knowledge and Adherence to the National Guidelines for Malaria Diagnosis in Pregnancy among Health-Care Providers and Drug-Outlet Dispensers in Rural Western Kenya. PloS ONE 11: e0145616.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Wu S, Roychowdhury I, Khan M, 2017. Evaluations of training programs to improve human resource capacity for HIV, malaria, and TB control: a systematic scoping review of methods applied and outcomes assessed. Trop Med Health 45: 16.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Rowe AK, Rowe SY, Peters DH, Holloway KA, Chalker J, Ross-Degnan D, 2018. Effectiveness of strategies to improve health-care provider practices in low-income and middle-income countries: a systematic review. Lancet Glob Health 6: e1163e1175.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    The Health Communication Capacity Collaborative, 2017. Malaria SBCC Evidence Literature Review. Baltimore, MD: Johns Hopkins Center for Communication Programs.

  • 25.

    Mikkelsen-Lopez I, Shango W, Barrington J, Ziegler R, Smith T, deSavigny D, 2014. The challenge to avoid anti-malarial medicine stock-outs in an era of funding partners: the case of Tanzania. Malar J 13: 181.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Githinji S et al. 2013. Reducing stock-outs of life saving malaria commodities using mobile phone text-messaging: SMS for life study in Kenya. PLoS One 8: e54066.

  • 27.

    Sun Y et al. 2018. Evaluating the quality of routinely reported data on malaria commodity stocks in Guinea, 2014–2016. Malar J 17: 461.

  • 28.

    Pulford J, Siba PM, Mueller I, Hetzel MW, 2014. The exit interview as a proxy measure of malaria case management practice: sensitivity and specificity relative to direct observation. BMC Health Serv Res 14: 628.

    • PubMed
    • Search Google Scholar
    • Export Citation
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