Assessing Compliance With Test And Treat Of The Malaria T3 Policy In Twifo/Atti Morkwa District

ABSTRACT

Background: Malaria treatment policy has changed from presumptions based on signs and symptoms to specific drug treatment after positive test results. The Ghana NMCP signed up to the WHO policy known as the test, treat and track (T3) which stipulates that all cases of malaria must be treated only after they have been confirmed by means of a laboratory test. Ghana has however not reached the level proposed for the elimination of malaria as still not all suspected cases are tested which suggest that compliance with the policy and some other factors could be the cause.

Objective: The study sought to assess compliance with the test and treat of the malaria T3 policy by determining the proportion of patients confirmed by testing, ACT antimalarial prescribed, prescribers who complied with the policy, and factors associated with prescriber compliance.

Method: The study used a descriptive cross-sectional approach in 7 facilities. It was conducted in Twifo/Atti Morkwa district where patient records were reviewed and interviews conducted with prescribers in the 7 selected facilities. Pearson Chi-square test was done to establish possible associations between the categorical variables using some patient, prescriber and facility factors as the independent variables and compliance as the dependent variable. Logistics regression analysis was then done on those significant independent variables to determine their association with compliance.

Outcome: Of the 572 patient records reviewed, 29.7% were children under five years and 59.6% of the patients were females. 28.57% of prescribers interviewed were physician assistants and 57% of facilities used for the study were CHPS facilities. Prescriber

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compliance was high (75%), patients tested before treatment was 80%, patients given ACT according to the policy were 97%. Factors identified to influence compliance include: patient age, a symptom of fever presented by patient and health facility type

Conclusion: Prescriber compliance with the test and treat policy in the Twifo/Atti Morkwa district was high. From this study, prescribers were more likely to comply with the policy if patients were younger in age and prescribers at higher facilities were more compliant than those at lower-level facilities and when patients present with elevated fever.

Keywords: Malaria, prescriber, compliance, fever, tested, treated, ACT, RDT