Evaluation of anti-malarial treatment for elimination of malaria in South West Ethiopia: a concurrent triangulation design for prompt decision
Abstract Background Malaria case management is a vital component of strategies to ensure malaria elimination programme. Despite continuous preventive strategies in place, malaria remains a major public health problem in resource-limited countries particularly in Ethiopia due to treatment-related pro...
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BMC
2025-07-01
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| Series: | Malaria Journal |
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| Online Access: | https://doi.org/10.1186/s12936-025-05396-5 |
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| author | Mathewos Alemu Gebremichael Tadesse Gebremedhin Wondwossen Niguse Girma Mamo Bezuayehu Alemayehu Ephrem Negeri Ibrahim Temam Haile Zewude Tamerat Bogale Endale Sahile Erkyihun Pawlos |
| author_facet | Mathewos Alemu Gebremichael Tadesse Gebremedhin Wondwossen Niguse Girma Mamo Bezuayehu Alemayehu Ephrem Negeri Ibrahim Temam Haile Zewude Tamerat Bogale Endale Sahile Erkyihun Pawlos |
| author_sort | Mathewos Alemu Gebremichael |
| collection | DOAJ |
| description | Abstract Background Malaria case management is a vital component of strategies to ensure malaria elimination programme. Despite continuous preventive strategies in place, malaria remains a major public health problem in resource-limited countries particularly in Ethiopia due to treatment-related problems. Hence, this study aimed to determine the level of adherence to malaria diagnosis and treatment guidelines among healthcare providers working in the public health facilities in Southwest Ethiopian Peoples Regional State (SWEPRS). Methods A facility-based cross-sectional study triangulated with qualitative inquiry was applied from March 2024 and July 2024. A multi-stage stratified and purposive sampling technique was used for the quantitative and qualitative study, respectively. Data were collected by the records review, Focus Group Discussions (FGDs), and In-depth Interviews (IDIs). The adherence of healthcare providers was evaluated according to recommendations of the current malaria diagnosis and treatment guidelines. The findings in the qualitative analysis were presented in the thematic analysis and triangulated with the quantitative findings. Results 1,684 patient cards were reviewed. The mean age of patients was 20.99 (± 15.61) years. 1,616 (95.96%) patients were screened through microscopy and/or multispecies rapid diagnostic tests (RDT). The overall adherence of healthcare providers to the updated malaria treatment standards was 36.99% (95%CI: 33.93–38.52%) and the majority, 982 (58.31%) were diagnosed with Plasmodium falciparum followed by Plasmodium vivax, and mixed infections. Shortage of anti-malarial drugs was reported as the foremost barrier followed by lack of training on the updated malaria case management guideline, shortage of health professionals, and lack of laboratory materials. In addition, shortage of electric supply, shortage of computers, shortage of outpatient department (OPD) rooms, lack of transport, distance from a health facility, community resistance, improper use of prescribed anti-malarial drugs, perceived inefficacy of drugs, inability to afford the anti-malarial drugs, lack of new malaria case management guideline, lack of private pharmacy, language barriers, and poor quality of Giemsa, were identified barriers. Conclusions The adherence level of healthcare providers was found to be low. Hence, ensuring the availability of all nationally recommended anti-malarial drugs and supplies, qualified health professionals, providing continuous training, strengthening continuous follow-up and supervision in the public health facilities are recommended to improve the adherence level of health professionals to national malaria treatment guideline. |
| format | Article |
| id | doaj-art-1643139084d945ffa09a91122c0f86f3 |
| institution | Kabale University |
| issn | 1475-2875 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj-art-1643139084d945ffa09a91122c0f86f32025-08-20T04:01:47ZengBMCMalaria Journal1475-28752025-07-0124111410.1186/s12936-025-05396-5Evaluation of anti-malarial treatment for elimination of malaria in South West Ethiopia: a concurrent triangulation design for prompt decisionMathewos Alemu Gebremichael0Tadesse Gebremedhin1Wondwossen Niguse2Girma Mamo3Bezuayehu Alemayehu4Ephrem Negeri5Ibrahim Temam6Haile Zewude7Tamerat Bogale8Endale Sahile9Erkyihun Pawlos10Department of Public Health, College of Health Sciences, Bonga UniversityDepartment of Public Health, College of Health Sciences, Bonga UniversityDepartment of Midwifery, College of Medicine and Health Sciences, Mizan-Tepi UniversityMizan-Aman College of Health SciencesDepartment of Environmental Health, College of Medicine and Health Sciences, Mizan-Tepi UniversitySouthwest Ethiopian Peoples Regional Health BureauSouthwest Ethiopian Peoples Regional Health BureauSouthwest Ethiopian Peoples Regional Health BureauPublic Health Institute, Southwest Ethiopian Peoples Regional Health BureauDiseases Prevention and Health Promotion Directorate, Southwest Ethiopian Peoples Regional Health BureauDepartment of Medicine, Mizan Tepi UniversityAbstract Background Malaria case management is a vital component of strategies to ensure malaria elimination programme. Despite continuous preventive strategies in place, malaria remains a major public health problem in resource-limited countries particularly in Ethiopia due to treatment-related problems. Hence, this study aimed to determine the level of adherence to malaria diagnosis and treatment guidelines among healthcare providers working in the public health facilities in Southwest Ethiopian Peoples Regional State (SWEPRS). Methods A facility-based cross-sectional study triangulated with qualitative inquiry was applied from March 2024 and July 2024. A multi-stage stratified and purposive sampling technique was used for the quantitative and qualitative study, respectively. Data were collected by the records review, Focus Group Discussions (FGDs), and In-depth Interviews (IDIs). The adherence of healthcare providers was evaluated according to recommendations of the current malaria diagnosis and treatment guidelines. The findings in the qualitative analysis were presented in the thematic analysis and triangulated with the quantitative findings. Results 1,684 patient cards were reviewed. The mean age of patients was 20.99 (± 15.61) years. 1,616 (95.96%) patients were screened through microscopy and/or multispecies rapid diagnostic tests (RDT). The overall adherence of healthcare providers to the updated malaria treatment standards was 36.99% (95%CI: 33.93–38.52%) and the majority, 982 (58.31%) were diagnosed with Plasmodium falciparum followed by Plasmodium vivax, and mixed infections. Shortage of anti-malarial drugs was reported as the foremost barrier followed by lack of training on the updated malaria case management guideline, shortage of health professionals, and lack of laboratory materials. In addition, shortage of electric supply, shortage of computers, shortage of outpatient department (OPD) rooms, lack of transport, distance from a health facility, community resistance, improper use of prescribed anti-malarial drugs, perceived inefficacy of drugs, inability to afford the anti-malarial drugs, lack of new malaria case management guideline, lack of private pharmacy, language barriers, and poor quality of Giemsa, were identified barriers. Conclusions The adherence level of healthcare providers was found to be low. Hence, ensuring the availability of all nationally recommended anti-malarial drugs and supplies, qualified health professionals, providing continuous training, strengthening continuous follow-up and supervision in the public health facilities are recommended to improve the adherence level of health professionals to national malaria treatment guideline.https://doi.org/10.1186/s12936-025-05396-5AdherenceMalariaGuidelinePublic HealthSouthwestEthiopia |
| spellingShingle | Mathewos Alemu Gebremichael Tadesse Gebremedhin Wondwossen Niguse Girma Mamo Bezuayehu Alemayehu Ephrem Negeri Ibrahim Temam Haile Zewude Tamerat Bogale Endale Sahile Erkyihun Pawlos Evaluation of anti-malarial treatment for elimination of malaria in South West Ethiopia: a concurrent triangulation design for prompt decision Malaria Journal Adherence Malaria Guideline Public Health Southwest Ethiopia |
| title | Evaluation of anti-malarial treatment for elimination of malaria in South West Ethiopia: a concurrent triangulation design for prompt decision |
| title_full | Evaluation of anti-malarial treatment for elimination of malaria in South West Ethiopia: a concurrent triangulation design for prompt decision |
| title_fullStr | Evaluation of anti-malarial treatment for elimination of malaria in South West Ethiopia: a concurrent triangulation design for prompt decision |
| title_full_unstemmed | Evaluation of anti-malarial treatment for elimination of malaria in South West Ethiopia: a concurrent triangulation design for prompt decision |
| title_short | Evaluation of anti-malarial treatment for elimination of malaria in South West Ethiopia: a concurrent triangulation design for prompt decision |
| title_sort | evaluation of anti malarial treatment for elimination of malaria in south west ethiopia a concurrent triangulation design for prompt decision |
| topic | Adherence Malaria Guideline Public Health Southwest Ethiopia |
| url | https://doi.org/10.1186/s12936-025-05396-5 |
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