Browsing by Author "Kaula, Henry"

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Adherence and Associated Factors to Intergrated Management of Malaria Guidelines in Lake Shore Facilities in the Districts of Buyende and Kaliro, Uganda
(International Health Sciences University., 2016-11) Kaula, Henry
Background: Malaria is a life-threatening disease. In Uganda, the Ministry of Health adopted the artemisinin combination therapy (ACT) artemether/lumefantrine (AL) 20mg/120mg as the first-line treatment for uncomplicated malaria in 2004(MoH, 2012). Further, Uganda also adopted the WHO (2012) guidelines of testing all suspected cases of malaria prior to treatment (MoH, 2012). It’s unclear whether health care providers in these districts adhere to the Ministry of Health (2012) guidelines for malaria management. Objectives of the study: The objective of this study was to assess level of adherence and associated factors to national malaria management guidelines by health providers in lake shore areas in Uganda. Methods: A cross sectional study design used and data was collected from patients and providers from selected health facilities. A total of 286 patients were screened and 197 were eligible and consented to participate in the study. A total of 26 health care providers were interviewed. Results: Appropriate medical history taking and physical examination was only reported by 8.1% of the patients, 65.5% were tested either using Rapid Diagnostic Testing kits (RDTs) or microscopy. Only 6.1% reported adherence to appropriate medical history & appropriate physical examination and testing for malaria. Regarding adherence to prescription guidelines, 18.6% of those who tested negative received an ACT drug/prescription, and 10.1% tested positive but did not receive an ACT drug or prescription. Overall adherence to all guidelines (medical history, physical examination, testing, and prescription) was a mere 3.1% and health care provider training on the guidelines was the only factor associated with adherence. Conclusion and recommendations: The overall level of adherence to the national malaria management guidelines was very low with only 3.1% of the patients managed in strict adherence to the national malaria management guidelines by the health care providers. This calls for health care provider trainings on malaria management to improve adherence.
Cross‐sectional study on the adherence to malaria guidelines in lakeshore facilities of Buyende and Kaliro districts, Uganda
(Bio Med Central, 2018-11-19) Kaula, Henry; Kiconco, Sylvia; Luigi, Nunez
Background: Uganda adopted the Integrated Management of Malaria (IMM) guidelines, which require testing all suspected cases of malaria prior to treatment and which have been implemented throughout the country. However, adherence to IMM guidelines has not been explicitly investigated, especially in lakeshore areas such as Buyende and Kaliro, two districts that remain highly burdened by malaria. This study assesses the level of adherence to IMM guidelines and pinpoints factors that influence IMM adherence by health providers in Buyende and Kaliro. A cross-sectional study among 197 patients and 26 healthcare providers was conducted. The algorithm for adherence to IMM guidelines was constructed to include physical examination, medical history, laboratory diagnosis, and anti-malarial drug prescription. Adherence was measured as a binary variable, and binary regression was used to identify factors associated with adherence to IMM guidelines. Results: Only 16 (8.1%) of the 197 patients had their medical history and physical examinations taken, while the majority (65.5%) of the patients were recommended for malaria (laboratory) testing. Regarding adherence to prescription guidelines, 127 (64.5%) of the patients received artemisinin combination therapy (ACT) drug prescription. On the other hand, 18.6% of those who tested negative received an ACT drug/prescription and 10.1% tested positive but did not receive an ACT drug or prescription. Overall adherence to IMM guidelines was only 3.1%. The only factor that significantly influenced adherence to IMM guidelines was training; healthcare providers who had attended recent training on these guidelines were almost three times more likely to adhere to the IMM guidelines compared to those who had not attended recent training (OR = 2.858, 95% CI 1.754–4.659). Conclusions: The findings indicate very low levels of adherence to IMM guidelines among healthcare workers in the lakeshore areas of Kaliro and Buyende districts. Since adherence was independently influenced, majorly by training healthcare workers on these guidelines, recommendations include facilitating training on IMM guidelines throughout Uganda.