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1.
PLoS One ; 18(10): e0276412, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37883486

RESUMO

INTRODUCTION: Appropriate management of malaria demands early health seeking behaviour upon suspicion of malaria-like symptoms. This study examined malaria treatment seeking behaviour and associated factors among international students at University of Ghana. METHODS: The study used a cross-sectional and quantitative approach. Data collection was undertaken using a structured questionnaire administered on a random sample of 264 international students. Data obtained on malaria treatment and factors influencing treatment behaviors were analyzed using IBM, SPSS Statistics version 22. Associations between individual characteristics and Malaria treatment seeking behavior was assessed by Pearson Chi-square(X2) test of independence. Binary logistic regression model was built using a backwards Wald approach, with variables retained at Wald p-value <0.05. RESULTS: The findings show that 35% of the respondents obtained self-prescribed antimalarial at their utmost first choice of Malaria treatment. At bivariate level, a significant relationship between Malaria health-care seeking behaviour and:- Respondents continent, X2(1, N = 264) = 7.936, p = .005; Service accessibility, X2(1, N = 264) = 7.624, p = .006; Wait time, X2(1, N = 264) = 22.514, p <0.001; Treatment cost, X2(1, N = 264) = 97.160, p <0.001; Health insurance, X2(1, N = 264) = 5.837, p = 0.016, and Perceived staff attitude, X2(1, N = 264) = 18.557, p < 0.001. At multivariable analysis, inappropriate malaria health seeking behaviours was associated with low perceived service accessibility as (≥30mins) (aOR = 6.67; p<0.001), perceived long wait time (≥30mins), (aOR = 5.94; p = 0.015), perceived treatment cost affordability (<15 GHC) (aOR = 19.88; p<0.001) and age group: -34-41years (aOR = 8.83; p<0.001). CONCLUSION: There were widespread inappropriate health-care seeking behavior for Malaria treatment among international students. Improving accessibility to malaria treatment services, reducing wait time at health facilities and the treatment cost will address inappropriate malaria treatment health seeking behaviours among the international students.


Assuntos
Malária , Humanos , Estudos Transversais , Malária/terapia , Malária/diagnóstico , Aceitação pelo Paciente de Cuidados de Saúde , Custos de Cuidados de Saúde , Estudantes , Gana
2.
East Afr Health Res J ; 7(1): 7-19, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37529501

RESUMO

Introduction: It is crucial to have satisfactory coverage of safe motherhood services in order to prevent birth defects and child disabilities. Mildmay Uganda Institute of Health Sciences (MIHS) implemented a safe motherhood project aimed at preventing birth defects and child disabilities. Methods: Three years after the project's implementation, a rapid cross-sectional health facility survey was conducted in 4 districts of central Uganda to assess the coverage of key safe motherhood and early childhood services. The Lot Quality Assurance Sampling approach was used to assess coverage of 16 indicators in the areas of ANC, skilled birth attendance, early childhood care, postnatal care, and knowledge about child disability prevention. A Decision Rule was set at 80% upper threshold to classify the performance of health facilities at the district level. Results: The survey found that there was variation in performance across indicators and districts. All districts achieved the 80% coverage target in ANC first visit, mothers who received at least two doses of Fansidar for intermittent preventive treatment of malaria in pregnancy, and mothers with knowledge of the action to take in case they suspect childhood disability. Folic acid supplementation during pregnancy and screening for birth defects using the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score had overall coverage above the target, but one district each had coverage below target in each of these 2 indicators. The coverage target was not reached in the rest of the survey indicators in each of the districts. Conclusion: Well-performing districts, especially in indicators with inconsistent performance, offer valuable insights for learning and adapting interventions in districts that do not meet the desired coverage of those particular indicators. Considering the disparities in performance among different indicators and districts, project planners should adopt, modify and implement successful strategies in districts and indicators that perform well. By doing so, they can enhance the performance of under performing districts or indicators.

3.
Malar J ; 20(1): 250, 2021 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-34090419

RESUMO

BACKGROUND: Although microscopy remains the gold standard for malaria diagnosis, little is known about its accuracy in the private health facilities in Uganda. This study evaluated the accuracy of malaria microscopy, and factors associated with inaccurate smear results at private health facilities in Entebbe Municipality, Uganda. METHODS: Between April and May 2018, all patients referred for a malaria smear in 16 private health facilities in Entebbe municipality were screened, and 321 patients were enrolled. A questionnaire was administered to collect demographic and clinical information, facility-based smear results were recorded from the participant's consultation notes, and a research slide was obtained for expert microscopy during exit interview. A health facility assessment was conducted, and information on experience in performing malaria microscopy was collected from all facility personnel reading smears and the data was linked to the participant's clinic visit. RESULTS: The test positivity rate of malaria parasitaemia was 15.0% by expert microscopy. The sensitivity, specificity and negative predictive value of the facility-based microscopy were high (95.8%, 90.1 and 99.2%, respectively). However; the positive predictive value (PPV) was low with 27/73 (63%) patients diagnosed with malaria not having the disease. Majority of the inaccurate results were from 2 of the 23 laboratory personnel reading the smears. The factors associated with inaccurate smear readings included being read by a technician; (1) who had less than 5 years' experience in reading malaria smears (adjusted Odds Ratio [aOR] = 9.74, 95% confidence interval [CI] (1.06-89.5), p-value = 0.04), and (2) who was examining less than 5 smears a day (aOR = 38.8, 95% CI 9.65-156, p-value < 0.001). CONCLUSIONS: The accuracy of malaria microscopy in this setting was high, although one third of the patients diagnosed with malaria did not have the disease. Majority of the errors in smear readings were made by two laboratory personnel, with the main factor associated with inaccurate smear results being low experience in malaria microscopy. In-service training may be sufficient to eliminate inaccurate smear results in this setting, and these private facilities would be ideal model facilities to improve the quality of malaria microscopy in Uganda especially in the public sector where accuracy is still poor.


Assuntos
Testes Diagnósticos de Rotina/estatística & dados numéricos , Instalações de Saúde/estatística & dados numéricos , Malária/diagnóstico , Instalações Privadas/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Estudos Transversais , Confiabilidade dos Dados , Feminino , Humanos , Masculino , Microscopia/métodos , Pessoa de Meia-Idade , Uganda , Adulto Jovem
4.
Soc Sci Humanit Open ; 2(1): 100045, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-34173490

RESUMO

Considering the COVID-19 global public health crisis, this paper examines the socio-cultural, economic and psychosocial impact of the pandemic on urban refugees in Uganda. We analyse the living conditions of urban refugees that make it problematic for them to adhere to public health measures. Since COVID-19 is perceived as "imported", refugees are assumed as its potential transmitters, consequently experiencing heightened stigma and isolation. Lack of culturally and linguistically accessible information and services excludes them from on-going efforts to prevent the pandemic. The lockdown has affected refugee livelihoods and increased income insecurity, sexual and gender-based violence and anxiety. Given the paucity of government-led services to contain the epidemic, we argue that contingency planning must involve refugees and their communities to access accurate and relevant information in appropriate languages. It is also important to build the capacity of frontline workers to understand the specific needs of refugees to deliver appropriate protection in the context of the pandemic.

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