Acceptability of Rapid Diagnostic Test-Based Management of Malaria among Caregivers of Under-Five Children in Rural Ghana 英文参考文献.docVIP

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Acceptability of Rapid Diagnostic Test-Based Management of Malaria among Caregivers of Under-Five Children in Rural Ghana 英文参考文献.doc

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Acceptability of Rapid Diagnostic Test-Based Management of Malaria among Caregivers of Under-Five Children in Rural Ghana 英文参考文献

AcceptabilityofRapidDiagnosticTest-Based ManagementofMalariaamongCaregiversofUnder-Five ChildreninRuralGhana FrankBaiden1*,SethOwusu-Agyei1,EuniceOkyere2,MathildaTivura1,GeorgeAdjei3, DanielChandramohan4,JayneWebster5 1Malaria Group, Kintampo Health Research Centre, Kintampo, Ghana, 2Social Science Group, Kintampo Health Research Centre, Kintampo, Ghana, 3Statistics Unit, Kintampo Health Research Centre, Kintampo, Ghana, 4Department for Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom, 5DepartmentforDiseaseControl,LondonSchoolofHygieneandTropicalMedicine,London,UnitedKingdom Abstract Introduction: WHO now recommends test-based management of malaria (TBMM) across all age-groups. This implies artemisinin-basedcombinationtreatment(ACT)shouldberestrictedtorapiddiagnostictest(RDT)-positivecases.Thisisa departurefromwhatcaregiversinruralcommunitieshavebeenusedtoformanyyears. Methods:Weconductedasurveyamongcaregiverslivingcloseto32healthcentresinsixdistrictsinruralGhanaandused logisticregressiontoexplorefactorslikelytoinfluencecaregiveracceptabilityofRDTbasedcasemanagementandconcern about the denial of ACT on account of negative RDT results. Focus group discussions were conducted to explain the quantitativefindingsandtoelicitfurtherfactors. Results:Atotalof3047caregiverswereinterviewed.Nearlyall(98%)reportedapreference forTBMMoverpresumptive treatment.CaregiverswhopreferredTBMMwerelesslikelytobeconcernedaboutthedenialofACTtotheirtest-negative children(O.R.0.57,95%C.I.0.33–0.98).Comparedwithcaregiverswhohadneversecurednationalhealthinsurancecover, caregiverswhohadvalid(adjustedO.R.1.30,95%CI1.07–1.61)orexpired(adjustedO.R.1.38,95%CI1.12–1.73)insurance coverweremorelikelytobeconcernedaboutthedenialofACTtotheirRDT-negativechildren.Majorfactorsthatpromote TBMMacceptabilityincludetheperceptionthatabloodtestathealthcentrelevelrepresentsimprovementinthequalityof care, leads to improvement in treatment outcomes, and offers opportunit