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Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda
BACKGROUND: Many malarious countries plan to introduce artemisinin combination therapy (ACT) at community level using community health workers (CHWs) for treatment of uncomplicated malaria. Use of ACT with reliance on presumptive diagnosis may lead to excessive use, increased costs and rise of drug...
Autores principales: | , , , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2010
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2914066/ https://www.ncbi.nlm.nih.gov/pubmed/20626863 http://dx.doi.org/10.1186/1475-2875-9-203 |
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author | Mukanga, David Tibenderana, James K Kiguli, Juliet Pariyo, George W Waiswa, Peter Bajunirwe, Francis Mutamba, Brian Counihan, Helen Ojiambo, Godfrey Kallander, Karin |
author_facet | Mukanga, David Tibenderana, James K Kiguli, Juliet Pariyo, George W Waiswa, Peter Bajunirwe, Francis Mutamba, Brian Counihan, Helen Ojiambo, Godfrey Kallander, Karin |
author_sort | Mukanga, David |
collection | PubMed |
description | BACKGROUND: Many malarious countries plan to introduce artemisinin combination therapy (ACT) at community level using community health workers (CHWs) for treatment of uncomplicated malaria. Use of ACT with reliance on presumptive diagnosis may lead to excessive use, increased costs and rise of drug resistance. Use of rapid diagnostic tests (RDTs) could address these challenges but only if the communities will accept their use by CHWs. This study assessed community acceptability of the use of RDTs by Ugandan CHWs, locally referred to as community medicine distributors (CMDs). METHODS: The study was conducted in Iganga district using 10 focus group discussions (FGDs) with CMDs and caregivers of children under five years, and 10 key informant interviews (KIIs) with health workers and community leaders. Pre-designed FGD and KII guides were used to collect data. Manifest content analysis was used to explore issues of trust and confidence in CMDs, stigma associated with drawing blood from children, community willingness for CMDs to use RDTs, and challenges anticipated to be faced by the CMDs. RESULTS: CMDs are trusted by their communities because of their commitment to voluntary service, access, and the perceived effectiveness of anti-malarial drugs they provide. Some community members expressed fear that the blood collected could be used for HIV testing, the procedure could infect children with HIV, and the blood samples could be used for witchcraft. Education level of CMDs is important in their acceptability by the community, who welcome the use of RDTs given that the CMDs are trained and supported. Anticipated challenges for CMDs included transport for patient follow-up and picking supplies, adults demanding to be tested, and caregivers insisting their children be treated instead of being referred. CONCLUSION: Use of RDTs by CMDs is likely to be acceptable by community members given that CMDs are properly trained, and receive regular technical supervision and logistical support. A well-designed behaviour change communication strategy is needed to address the anticipated programmatic challenges as well as community fears and stigma about drawing blood. Level of formal education may have to be a criterion for CMD selection into programmes deploying RDTs. |
format | Text |
id | pubmed-2914066 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-29140662010-08-03 Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda Mukanga, David Tibenderana, James K Kiguli, Juliet Pariyo, George W Waiswa, Peter Bajunirwe, Francis Mutamba, Brian Counihan, Helen Ojiambo, Godfrey Kallander, Karin Malar J Research BACKGROUND: Many malarious countries plan to introduce artemisinin combination therapy (ACT) at community level using community health workers (CHWs) for treatment of uncomplicated malaria. Use of ACT with reliance on presumptive diagnosis may lead to excessive use, increased costs and rise of drug resistance. Use of rapid diagnostic tests (RDTs) could address these challenges but only if the communities will accept their use by CHWs. This study assessed community acceptability of the use of RDTs by Ugandan CHWs, locally referred to as community medicine distributors (CMDs). METHODS: The study was conducted in Iganga district using 10 focus group discussions (FGDs) with CMDs and caregivers of children under five years, and 10 key informant interviews (KIIs) with health workers and community leaders. Pre-designed FGD and KII guides were used to collect data. Manifest content analysis was used to explore issues of trust and confidence in CMDs, stigma associated with drawing blood from children, community willingness for CMDs to use RDTs, and challenges anticipated to be faced by the CMDs. RESULTS: CMDs are trusted by their communities because of their commitment to voluntary service, access, and the perceived effectiveness of anti-malarial drugs they provide. Some community members expressed fear that the blood collected could be used for HIV testing, the procedure could infect children with HIV, and the blood samples could be used for witchcraft. Education level of CMDs is important in their acceptability by the community, who welcome the use of RDTs given that the CMDs are trained and supported. Anticipated challenges for CMDs included transport for patient follow-up and picking supplies, adults demanding to be tested, and caregivers insisting their children be treated instead of being referred. CONCLUSION: Use of RDTs by CMDs is likely to be acceptable by community members given that CMDs are properly trained, and receive regular technical supervision and logistical support. A well-designed behaviour change communication strategy is needed to address the anticipated programmatic challenges as well as community fears and stigma about drawing blood. Level of formal education may have to be a criterion for CMD selection into programmes deploying RDTs. BioMed Central 2010-07-13 /pmc/articles/PMC2914066/ /pubmed/20626863 http://dx.doi.org/10.1186/1475-2875-9-203 Text en Copyright ©2010 Mukanga et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Mukanga, David Tibenderana, James K Kiguli, Juliet Pariyo, George W Waiswa, Peter Bajunirwe, Francis Mutamba, Brian Counihan, Helen Ojiambo, Godfrey Kallander, Karin Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda |
title | Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda |
title_full | Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda |
title_fullStr | Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda |
title_full_unstemmed | Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda |
title_short | Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda |
title_sort | community acceptability of use of rapid diagnostic tests for malaria by community health workers in uganda |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2914066/ https://www.ncbi.nlm.nih.gov/pubmed/20626863 http://dx.doi.org/10.1186/1475-2875-9-203 |
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