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Determinants of malaria diagnostic uptake in the retail sector: qualitative analysis from focus groups in Uganda

BACKGROUND: In Uganda, as in most other malaria-endemic countries, presumptive treatment for malaria based on symptoms without a diagnostic blood test is still very common. While diagnostic testing in public sector facilities is increasing, many people in Uganda who suspect malaria visit private sec...

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Autores principales: Cohen, Jessica, Cox, Alex, Dickens, William, Maloney, Kathleen, Lam, Felix, Fink, Günther
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338828/
https://www.ncbi.nlm.nih.gov/pubmed/25884736
http://dx.doi.org/10.1186/s12936-015-0590-x
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author Cohen, Jessica
Cox, Alex
Dickens, William
Maloney, Kathleen
Lam, Felix
Fink, Günther
author_facet Cohen, Jessica
Cox, Alex
Dickens, William
Maloney, Kathleen
Lam, Felix
Fink, Günther
author_sort Cohen, Jessica
collection PubMed
description BACKGROUND: In Uganda, as in most other malaria-endemic countries, presumptive treatment for malaria based on symptoms without a diagnostic blood test is still very common. While diagnostic testing in public sector facilities is increasing, many people in Uganda who suspect malaria visit private sector outlets to purchase medications. Increasing the availability and uptake of rapid diagnostic tests (RDTs) for malaria in private outlets could help increase diagnostic testing for malaria but raises questions about the patient demand for and valuation of testing that are less critical for public sector introduction. METHODS: In preparation for a behaviour change campaign to encourage and sustain the demand for RDTs in drug shops, eight focus group discussions with a total of 84 community members were conducted in six districts across Uganda’s Eastern Region in November-December 2011. Focus groups explored incentives and barriers to seeking diagnosis for malaria, how people react to test results and why, and what can be done to increase the willingness to pay for RDTs. RESULTS: Overall, participants were very familiar with malaria diagnostic testing and understood its importance, yet when faced with limited financial resources, patients preferred to spend their money on medication and sought testing only when presumptive treatment proved ineffective. While side effects did seem to be a concern, participants did not mention other potential costs of taking unnecessary or ineffective medications, such as money wasted on excess drugs or delays in resolution of symptoms. Very few individuals were familiar with RDTs. CONCLUSION: In order to boost demand, these results suggest that private sector RDTs will have to be made convenient and affordable and that targeted behaviour change campaigns should strive to increase the perceived value of diagnosis.
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spelling pubmed-43388282015-02-25 Determinants of malaria diagnostic uptake in the retail sector: qualitative analysis from focus groups in Uganda Cohen, Jessica Cox, Alex Dickens, William Maloney, Kathleen Lam, Felix Fink, Günther Malar J Research BACKGROUND: In Uganda, as in most other malaria-endemic countries, presumptive treatment for malaria based on symptoms without a diagnostic blood test is still very common. While diagnostic testing in public sector facilities is increasing, many people in Uganda who suspect malaria visit private sector outlets to purchase medications. Increasing the availability and uptake of rapid diagnostic tests (RDTs) for malaria in private outlets could help increase diagnostic testing for malaria but raises questions about the patient demand for and valuation of testing that are less critical for public sector introduction. METHODS: In preparation for a behaviour change campaign to encourage and sustain the demand for RDTs in drug shops, eight focus group discussions with a total of 84 community members were conducted in six districts across Uganda’s Eastern Region in November-December 2011. Focus groups explored incentives and barriers to seeking diagnosis for malaria, how people react to test results and why, and what can be done to increase the willingness to pay for RDTs. RESULTS: Overall, participants were very familiar with malaria diagnostic testing and understood its importance, yet when faced with limited financial resources, patients preferred to spend their money on medication and sought testing only when presumptive treatment proved ineffective. While side effects did seem to be a concern, participants did not mention other potential costs of taking unnecessary or ineffective medications, such as money wasted on excess drugs or delays in resolution of symptoms. Very few individuals were familiar with RDTs. CONCLUSION: In order to boost demand, these results suggest that private sector RDTs will have to be made convenient and affordable and that targeted behaviour change campaigns should strive to increase the perceived value of diagnosis. BioMed Central 2015-02-21 /pmc/articles/PMC4338828/ /pubmed/25884736 http://dx.doi.org/10.1186/s12936-015-0590-x Text en © Cohen et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Cohen, Jessica
Cox, Alex
Dickens, William
Maloney, Kathleen
Lam, Felix
Fink, Günther
Determinants of malaria diagnostic uptake in the retail sector: qualitative analysis from focus groups in Uganda
title Determinants of malaria diagnostic uptake in the retail sector: qualitative analysis from focus groups in Uganda
title_full Determinants of malaria diagnostic uptake in the retail sector: qualitative analysis from focus groups in Uganda
title_fullStr Determinants of malaria diagnostic uptake in the retail sector: qualitative analysis from focus groups in Uganda
title_full_unstemmed Determinants of malaria diagnostic uptake in the retail sector: qualitative analysis from focus groups in Uganda
title_short Determinants of malaria diagnostic uptake in the retail sector: qualitative analysis from focus groups in Uganda
title_sort determinants of malaria diagnostic uptake in the retail sector: qualitative analysis from focus groups in uganda
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338828/
https://www.ncbi.nlm.nih.gov/pubmed/25884736
http://dx.doi.org/10.1186/s12936-015-0590-x
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