IntroductionEarly diagnosis and prompt and effective treatment is one of the pillars of malaria control. Malaria case management guidelines recommend diagnostic testing before treatment using malaria Rapid Diagnostic Test (mRDT) or microscopy and this was adopted in Nigeria in 2010. However, despite the deployment of mRDT, the use of mRDTs by health workers varies by settings. This study set out to assess factors influencing utilisation of mRDT among healthcare workers in Zamfara State, Nigeria.MethodsA cross-sectional study was carried out among 306 healthcare workers selected using multistage sampling from six Local Government Areas between January and February 2017. Mixed method was used for data collection. A pre-tested self-administered questionnaire was used to collect information on knowledge, use of mRDT and factors influencing utilization. An observational checklist was used to assess the availability of mRDT in the six months prior to this study. Data were analyzed using descriptive statistics such as means and proportions. Association between mRDT use and independent variables was tested using Chi square while multiple regression was used to determine predictors of use at 5% level of significance.ResultsMean age of respondents was 36.0 ± 9.4years. Overall, 198 (64.7%) of health workers had good knowledge of mRDT; mRDT was available in 33 (61.1%) facilities. Routine use of mRDT was reported by 253 (82.7%) healthcare workers. This comprised 89 (35.2%) laboratory scientists/technicians, 89 (35.2%) community health extension workers/community health officers; 59 (23.3%) nurses and 16 (6.3%) doctors. Health workers’ good knowledge of mRDT, trust in mRDT results, having received prior training on mRDT, and non-payment for mRDT were predictors of mRDT utilisation.ConclusionThis study demonstrated that healthcare worker utilisation of mRDT was associated with health worker and health system-related factors that are potentially modifiable. There is need to sustain training of healthcare workers on benefits of using mRDT and provision of free mRDT in health facilities.
Objectives: To determine the birth prevalence, trend, and characteristics of external structural birth defects occurrence in Enugu Metropolis, Nigeria.Design: Cross-sectional study involving review of delivery records.Setting: The study was conducted at three tertiary hospitals, one public and two missionary, in Enugu Metropolis.Participants: Mothers and their babies delivered between 1 January 2009 and 31 December 2016 in the study facilities.Main outcome measures: Birth prevalence of defects presented as frequency/10,000 births. Other descriptive variables are presented as frequencies and percentages.Results: There were 21530 births with 133 birth defects (birth prevalence: 61.8/10,000 births) and 1176 stillbirths (stillbirth rate: 54.6/1000 births). The frequencies and birth prevalence (/10,000 births) of recorded defects were: Limb deformities 60(27.9), Neural tube defects (NTDs): 36(16.7), Urogenital system defects: 12(5.6), Gastrointestinal system defects 10(4.6) and Orofacial clefts 4(1.9). Birth defects occurrence showed a rising trend from 2009 to 2016. The mean (SD) age of mothers whose babies had Birth defects was 29.1(4.7) years. Only 62(46.6%) of 133 antenatal clinic folders of these women were traceable for further review. Eighteen (29.0%) had febrile illness in early pregnancy, 9(14.5%) had Malaria, 17(27.4%) had <4 antenatal clinic attendance, 7(11.3%) did not take folic acid and 6(9.7%) took herbal medications during pregnancy.Conclusions: Birth defects occurrence showed a rising trend with limb deformities and NTDs having the highest prevalence. Record keeping was poor at the facilities. Birth defects preventive interventions like folic acid supplementation for women-of-childbearing age should be promoted in Enugu Metropolis.
16Introduction: Early diagnosis and prompt and effective treatment is one of the pillars of malaria 17 control Malaria case management guidelines recommend diagnostic testing before treatment 18 using malaria Rapid Diagnostic Test (mRDT) or microscopy and this was adopted in Nigeria in 19 2010. However, despite the deployment of mRDT, the use of mRDTs by health workers varies 20 by settings. This study set out to assess factors influencing utilisation of mRDT among 21 healthcare workers in Zamfara State, Nigeria. 22 Methods:A cross-sectional study was carried out among 306 healthcare workers selected using 23 multistage sampling from six Local Government Areas between January and February 2017. 24Mixed method was used for data collection. A pre-tested self-administered questionnaire was 25 used to collect information on knowledge, use of mRDT and factors influencing utilization. An 26 observational checklist was used to assess the availability of mRDT in the six months prior to 27 this study. Data were analyzed using descriptive statistics such as means and proportions. 28Association between mRDT use and independent variables was tested using Chi square while 29 multiple regression was used to determine predictors of use at 5% level of significance. 30 Results: Mean age of respondents was 36.0 ± 9.4years. Overall, 198 (64.7%) of health workers 31 had good knowledge of mRDT; malaria RDT was available in 33 (61.1%) facilities. Routine use 32 of mRDT was reported by 253 (82.7%) healthcare workers. This comprised 89 (35.2%) 33 laboratory scientists/technicians, 89 (35.2%) community health extension workers/community 34 health officers; 59 (23.3%) nurses and 16 (6.3%) doctors. Predictors of mRDT utilisation were 35 good knowledge of mRDT (adjusted OR (aOR):3.3, CI: 1.6-6.7), trust in mRDT results (aOR: 36 4.0, CI: 1.9 -8.2), having being trained on mRDT (aOR: 2.7, CI: 1.2 -6.6), and provision of free 37 mRDT (aOR: 2.3, CI: 1.0 -5.0). 38 Conclusion: This study demonstrated that healthcare worker utilisation of mRDT was associated 39 with health worker and health system-related factors that are potentially modifiable. There is 40 need to sustain training of healthcare workers on benefits of using mRDT and provision of free 41 mRDT in health facilities. 42 43 44 45 46 48 65 gold standard in malaria diagnosis, it has been limited in availability, often of poor quality, time-66 consuming, labor-intensive, and costly 7,8 especially in resource-poor settings. Lack of equipment,67reagents, and expertise for malaria microscopy in the majority of peripheral health centers and 68 the constant power supply has equally limited its use. More so, presumptive diagnosis based on 69 malaria symptoms has proven to be unspecific 9-11 . These shortcomings of microscopy and 70 presumptive diagnosis have favored the deployment and use of mRDTs which have been found 71 to be cost-effective 12-14 and allow diagnosis even in health settings lacking any laboratory 72 facility. Malaria RDT use is expected to not only improve malaria management b...
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