Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Dec 17:13:502.
doi: 10.1186/1475-2875-13-502.

Perceptions of malaria and acceptance of rapid diagnostic tests and related treatment practises among community members and health care providers in Greater Garissa, North Eastern Province, Kenya

Emma Diggle, Ramin Asgary, Georgia Gore-Langton, Erupe Nahashon, James Mungai, Rebecca Harrison, Abdullahi Abagira, Katie Eves, Zoya Grigoryan, David Soti, Elizabeth Juma, Richard Allan  1
Affiliations

Perceptions of malaria and acceptance of rapid diagnostic tests and related treatment practises among community members and health care providers in Greater Garissa, North Eastern Province, Kenya

Emma Diggle et al. Malar J. .

Abstract

Background: Conventional diagnosis of malaria has relied upon either clinical diagnosis or microscopic examination of peripheral blood smears. These methods, if not carried out exactly, easily result in the over- or under-diagnosis of malaria. The reliability and accuracy of malaria RDTs, even in extremely challenging health care settings, have made them a staple in malaria control programmes. Using the setting of a pilot introduction of malaria RDTs in Greater Garissa, North Eastern Province, Kenya, this study aims to identify and understand perceptions regarding malaria diagnosis, with a particular focus on RDTs, and treatment among community members and health care workers (HCWs).

Methods: The study was conducted in five districts of Garissa County. Focus group discussions (FGD) were performed with community members that were recruited from health facilities (HFs) supported by the MENTOR Initiative. In-depth interviews (IDIs) and FGDs with HCWs were also carried out. Interview transcripts were then coded and analysed for major themes. Two researchers reviewed all codes, first separately and then together, discussed the specific categories, and finally characterized, described, and agreed upon major important themes.

Results: Thirty-four FGDs were carried out with a range of two to eight participants (median of four). Of 157 community members, 103 (65.6%) were women. The majority of participants were illiterate and the highest level of education was secondary school. Some 76% of participants were of Somali ethnicity. Whilst community members and HCWs demonstrated knowledge of aspects of malaria transmission, prevention, diagnosis, and treatment, gaps and misconceptions were identified. Poor adherence to negative RDT results, unfamiliarity and distrust of RDTs, and an inconsistent RDT supply were the main challenges to become apparent in FGDs and IDIs.

Conclusion: Gaps in knowledge or incorrect beliefs exist in Greater Garissa and have the potential to act as barriers to complete and correct malaria case management. Addressing these knowledge gaps requires comprehensive education campaigns and a reliable and constant RDT supply. The results of this study highlight education and supply chain as key factors to be addressed in order to make large scale roll out of RDTs as successful and effective as possible.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The total numbers of malaria cases and numbers of artemether lumefantrine treatments distributed. Total number of AL treatments dispensed, confirmed malaria cases (microscopy and RDT), microscopy confirmed cases, and RDT confirmed cases across the study area between 2010 and 2013 and broken down in to yearly quarters (except 2010 data which was only collected over the period between September and December).
Figure 2
Figure 2
Map of the study area. A map of the study area of Greater Garissa, North Eastern Province, Kenya [30].
See this image and copyright information in PMC

References

    1. Johns Hopkins Malaria Research Institute . About Malaria. Baltimore: Johns Hopkins Bloomberg School of Public Health; 2014.
    1. WHO . World Malaria Report. Geneva: World Health Organization; 2013.
    1. Wongsrichanalai C, Barcus MJ, Muth S, Sutamihardja A, Wernsdorfer WH. A review of malaria diagnostic tools: microscopy and rapid diagnostic test (RDT) Am J Trop Med Hyg. 2007;77:119–127. - PubMed
    1. Harchut K, Standley C, Dobson A, Klaassen B, Rambaud-Althaus C, Althaus F, Nowak K. Over-diagnosis of malaria by microscopy in the Kilombero Valley, Southern Tanzania: an evaluation of the utility and cost-effectiveness of rapid diagnostic tests. Malar J. 2013;12:159. doi: 10.1186/1475-2875-12-159. - DOI - PMC - PubMed
    1. Reyburn H, Mbakilwa H, Mwangi R, Mwerinde O, Olomi R, Drakeley C, Whitty CJM. Rapid diagnostic tests compared with malaria microscopy for guiding outpatient treatment of febrile illness in Tanzania: randomised trial. BMJ. 2007;334:403. doi: 10.1136/bmj.39073.496829.AE. - DOI - PMC - PubMed

Publication types