Prescription of Anti-Malarial Drugs to Patients with Negative Malarial Rapid Diagnostic Test (mRDT) Result by Health Care Workers in Kano, Nigeria

Abstract

The World Health Organization and the National Malaria Treatment Guideline recommend parasitebased malaria diagnosis by light microscopy or Rapid Diagnostic Tests (RDTs). Positive result is the only indication for anti-malarial treatment whereas negative cases  should be reassessed for other common causes of fever. However, contrary to this and for reasons not to be cleared, health workers (HWs) still prescribe antimalarial to patients with negative malarial rapid diagnostic test (mRDT) results of antimalarial drug resistance. To  explore the possible reasons for this practice, we assessed compliance with the guidelines among healthcare workers and identified  factors associated with the prescription of antimalarial drugs to patients with negative mRDT results. Data on socio-demographic characteristics, years of professional experience, choice, and compliance to mRDT results, and management of fever were generated  using a questionnaire. We tested associations between these variables and the prescription of antimalarial drugs to patients with  negative mRDT results using Chisquare at P< 0.05 adopted as the level of significance. The study revealed that higher proportion of doctors and nurses (79.4% and 52.5%, p 0.001) and HWs with less than five years of clinical practice (60.8%, P<0.024), prescribed  antimalarial to patients with negative mRDT results. Our results demonstrated a significant lack of adherence to National health policy on  the treatment of malaria among young healthcare workers. The practice would presumably promote drug overuse and accelerate the  emergency visit of antimalarial drug resistance. We recommend the supervision and guidance of junior and early career healthcare  workers by their seniors to ensure compliance with test results and good healthcare practices.