[Evaluation of application of national guidelines for the management of malaria in Bobo-Dioulasso university hospital]

Sante Publique. 2015 Mar-Apr;27(2):265-73.
[Article in French]

Abstract

Introduction: To evaluate compliance with national guidelines concerning the diagnosis and treatment of malaria at Souro Sanou university hospital in Bobo-Dioulasso.

Methods: This was a cross-sectional descriptive study based on the medical records of patients hospitalised in the Medicine and Paediatrics departments in 2012. All cases labelled as “malaria” on admission and on discharge, for which the medical records were complete, were included in the study.

Results: Of the total of 1,722 cases collected, 1,674 cases (97.22%) were labelled as “severe malaria”. The mean age of these patients was 2.65 years [95% CI: 2.41-2.90 years]; 87.63% of cases were under the age of 5 years. The sex-ratio was 1.22. The diagnosis complied with guidelines in 13.82% of cases. The rate of compliance with the diagnosis did not differ according to the severity of the disease (p=0.78), but differed according to age-group: 13.12% in subjects under the age of 5 years versus 18.78% in subjects over the age of 5 years (p=0.02). Cases labelled as “severe malaria” (SM comprised 1.47% of cases of “uncomplicated malaria” (UCM); inversely, 4.17% cases of SM were identified among cases labelled as UCM. Overall, 242 cases (14.05%) were confirmed cases of malaria versus 1,480 cases (85.95%) of presumed malaria. Treatment complied with guidelines in 57.49% of cases. The adequate treatment rate was higher for cases of SM (58.90% versus 8.33%, p<0.01) and in children under the age of 5 years (58.71% versus 48.30%, p=0.02).

Conclusion: This study demonstrated poor compliance with clinical practice guidelines concerning the management of malaria in Bobo-Dioulasso university hospital. Identification of factors responsible for poor compliance with these guidelines may help to identify appropriate measures to improve compliance and contribute to control of malaria in the country.

Publication types

  • English Abstract

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antimalarials / therapeutic use
  • Burkina Faso
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Guideline Adherence*
  • Hospitals, University
  • Humans
  • Infant
  • Malaria / diagnosis
  • Malaria / drug therapy*
  • Malaria / physiopathology
  • Male
  • Medical Records
  • Middle Aged
  • Practice Guidelines as Topic*
  • Retrospective Studies
  • Severity of Illness Index
  • Young Adult

Substances

  • Antimalarials