Health workers’ compliance to rapid diagnostic tests (RDTs) to guide malaria treatment: a systematic review and meta-analysis

Malaria Journal

Research

Michèle van Vugt¹  Benjamin J. Visser²  Martin P. Grobusch²  Rene Spijker³  Kamija S. Phiri⁴  Alinune N. Kabaghe⁵ 

[1] Division of Internal Medicine, Department of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, PO Box 22700, Meibergdreef 9, 1100 DE, Amsterdam, The Netherlands;Division of Internal Medicine, Department of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, PO Box 22700, Meibergdreef 9, 1100 DE, Amsterdam, The Netherlands;Centre de Recherches de Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon;Medical Library, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands;Public Health Department, College of Medicine, Private Bag 360, Blantyre, Malawi;Public Health Department, College of Medicine, Private Bag 360, Blantyre, Malawi;Division of Internal Medicine, Department of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, PO Box 22700, Meibergdreef 9, 1100 DE, Amsterdam, The Netherlands;

关键词: Malaria;    Rapid diagnostic test (RDT);    Health workers;    Sub-Saharan Africa;    Plasmodium falciparum;    Clinical decision making;    Adherence;    Compliance;   

DOI  :  10.1186/s12936-016-1218-5

 received in 2016-01-12, accepted in 2016-03-05,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe World Health Organization recommends malaria to be confirmed by either microscopy or a rapid diagnostic test (RDT) before treatment. The correct use of RDTs in resource-limited settings facilitates basing treatment onto a confirmed diagnosis; contributes to speeding up considering a correct alternative diagnosis, and prevents overprescription of anti-malarial drugs, reduces costs and avoids unnecessary exposure to adverse drug effects. This review aims to evaluate health workers’ compliance to RDT results and factors contributing to compliance.MethodsA PROSPERO-registered systematic review was conducted to evaluate health workers’ compliance to RDTs in sub-Saharan Africa, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies published up to November 2015 were searched without language restrictions in Medline/Ovid, Embase, Cochrane Central Register of Controlled Trials, Web of Science, LILACS, Biosis Previews and the African Index Medicus. The primary outcome was health workers treating patients according to the RDT results obtained.ResultsThe literature search identified 474 reports; 14 studies were eligible and included in the quantitative analysis. From the meta-analysis, health workers’ overall compliance in terms of initiating treatment or not in accordance with the respective RDT results was 83 % (95 % CI 80–86 %). Compliance to positive and negative results was 97 % (95 % CI 94–99 %) and 78 % (95 % CI 66–89 %), respectively. Community health workers had higher compliance rates to negative test results than clinicians. Patient expectations, work experience, scepticism of results, health workers’ cadres and perceived effectiveness of the test, influenced compliance.ConclusionsWith regard to published data, compliance to RDT appears to be generally fair in sub-Saharan Africa; compliance to negative results will need to improve to prevent mismanagement of patients and overprescribing of anti-malarial drugs. Improving diagnostic capacity for other febrile illnesses and developing local evidence-based guidelines may help improve compliance and management of negative RDT results.Trial registration: CRD42015016151 (PROSPERO)

【 授权许可】

CC BY   
© Kabaghe et al. 2016