Impact of training of mothers, drug shop attendants and voluntary health workers on effective diagnosis and treatment of malaria in Lagos, Nigeria
Olusola Ajibaye1, Emmanuel O Balogun2, Yetunde A Olukosi1, Bassey A Orok1, Kolapo M Oyebola1, Bamidele A Iwalokun3, Olugbenga O Aina1, Olalere Shittu4, Adeniyi K Adeneye5, Oyesola O Ojewunmi6, K Kita5, Samson T Awolola7
1 Department of Biochemistry and Nutrition, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
2 Department of Biochemistry, Ahmadu Bello University, Zaria, Nigeria; Department of Biomedical Chemistry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
3 Department of Molecular Biology and Biotechnology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
4 Department of Zoology, Parasitology Unit, University of Ilorin, Ilorin, Nigeria
5 School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
6 Sickle Cell Foundation on Nigeria, Idi-Araba, Lagos, Nigeria
7 Department of Public Health and Molecular Entomology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
Biochemistry and Nutrition Division, Nigerian Institute of Medical Research, Yaba, Lagos
Source of Support: None, Conflict of Interest: None
Background: The National Malaria Eradication Program and international agencies are keen on scaling up the use of malaria rapid diagnostic tests (mRDTs) and artemisinin-based combination therapies (ACTs) for effective diagnosis and treatment of the disease. However, poor diagnostic skills and inappropriate treatment are limiting the efforts. In Nigeria, a large proportion of infected patients self-diagnose and treat while many others seek care from informal drug attendants and voluntary health workers.
Aims: This study describes the impact of training voluntary health workers, drug shop attendants, and mothers on effective case detection and treatment of malaria in Lagos, Nigeria. METHODS: We trained mothers accessing antenatal care, drug shop attendants, and voluntary health workers selected from the three districts of Lagos, on the use of histidine-rich protein-2-based mRDTs and ACTs. Pre- and post-training assessments, focus group discussions (FGDs), and in-depth interviews (IDIs) were carried out.
Results: The knowledge, attitude, and skill of the participants to achieve the goal of “test, treat, and track” using mRDT and ACTs were low (11%–55%). There was a low awareness of other non-malaria fevers among mothers. Self-medication was widely practiced (31.3%). FGDs and IDIs revealed that health-care providers administered antimalarials without diagnosis. Training significantly improved participants' knowledge and expertise on the use of mRDTs and ACTs (P = 0.02). The participants' field performance on mRDT use was significantly correlated with their category (bivariate r = 0.51, P = 0.001). There was no statistically significant association between the participants' level of education or previous field experience and their field performance on mRDT (r = 0.12, P = 0.9; χ2 = 38, df = 2 and P = 0.49).
Conclusion: These findings suggest that training of stakeholders in malaria control improves diagnosis and treatment of malaria. However, a broader scope of training in other settings may be required for an effective malaria control in Nigeria.