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Utilization of Malaria Diagnostic Tests and Receipt of Anti-Malarial Drugs by Febrile Patients Attending Outpatient Clinics of Health Centre IV Facilities in Mukono District, Uganda

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Health 2014年第13期6卷 1628-1642页

作者： Rose Naigino Achilles Katamba Harriet M. Babikako aggrey mukose Makerere University School of Public Health College of Health Sciences Kampala Uganda

Background: Failure to demonstrate the presence of malaria parasites prior to treatment with anti-malarial drugs remains a challenge in Uganda, often resulting into over-prescription of anti-malarial drugs to febrile patients suspected of malaria. The aim of this study was to describe the role of utilization of malaria diagnostic tests and associated factors in the receipt of anti-malarial drugs among febrile patients suspected of malaria. Methods: In a cross-sectional study design, client-exit interviews with febrile patients and key-informant interviews with purposively selected health workers were conducted at outpatient clinics of health centre IV facilities in Mukono district. Data entry and analysis were done using EpiData 3.2 and STATA 10 respectively. Data were described using frequency distributions and proportions. Chi square was used in two by two tables, odds ratios as the measure of association and an alpha level of 0.05 was used in all significance tests. Results: Out of 408 respondents, the majority were female (252, 61.8%) and a third of the samples were aged five years and below. The mean age in years was 3.3 with a standard deviation of 2.1. More than half of the respondents (359, 88%) utilized malaria diagnostic tests and about half (241, 59%) received anti-malarial drugs. There were no statistically significant differences between utilizers and non-utilizers in most characteristics except age, history of indoor residual spraying and perceived satisfaction with services at outpatient clinics. Utilizers were 75% less likely to receive anti-malarial drugs than non-utilizers after controlling for age, sex and residence (OR: 0.25, 95%CI: 0.09, 0.66). Frequent power cut-offs as well as limited knowledge on malaria treatment guidelines amongst laboratory personnel were some of the major limitations to microscopic diagnosis of malaria. Conclusion: Utilizers were 75% less likely to receive anti-malarial drugs as opposed to non-utilizers. This implies that

关键词： Malaria Diagnostic Test Febrile Malaria Suspect Utilizers Receipt of Anti-Malarial Drugs

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Client satisfaction with integrated community case management program in Wakiso District, Uganda, October 2012: A cross sectional survey

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Health 2013年第11期5卷 1889-1898页

作者： Nathan Tumuhamye Elizeus Rutebemberwa Doris Kwesiga James Bagonza aggrey mukose School of Public Health College of Health Sciences Makerere University Kampala Uganda

Background: Malaria, pneumonia and diarrhea are the leading causes of death in children under five years of age in Uganda. In a bid to improve access to prompt and effective treatment of these diseases, Malaria Consortium in partnership with United Nations International Children’s Emergency Fund (UNICEF) introduced Integrated Community Case Management (ICCM) in eight central districts of Uganda. There is currently limited information about client satisfaction with this program. The main objective of the study was to assess client satisfaction with the ICCM program in Wakiso district. Methods: A cross-sectional study using quantitative methods and a modified SERVQUAL tool was conducted and 454 care givers of children under five years of age were interviewed. Differences in mean scores between expected and perceived services were analyzed using paired t-tests and chi-square tests. A negative score implied that clients were not satisfied with the care they received. Logistic regression models were also used. Results: Among 454 respondents, 80% of the care givers of children under five were satisfied with ICCM program. The overall gap (-0.332) between expectations and perceptions was significant, (t = -4.89, p-value 0.0081) meaning that despite the high level of client satisfaction, there still existed a quality gap in services provided under ICCM. Furthermore, there were no significant differences in the expectation and perception scores among the different dimensions except for reliability which had a score of?-0.49 (p-value 0.0005). The multivariable logistic regression model showed that primary education (OR 2.8, 95% CI 1.12-6.80) and being a Muslim (OR 2.9, 95% CI 1.40-6.34) were significantly associated with client satisfaction. Conclusion: Overall, 80% of the clients were satisfied with ICCM services despite the overall quality gap in ICCM services and there was no statistical significant difference between perceptions and expectations for all the dimensions exce

关键词： Client Satisfaction Malaria Pneumonia Diarrhea Wakiso

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