Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), Ebonyi State, Nigeria.
PLoS One. 2021 Sep 20;16(9):e0257600. doi: 10.1371/journal.pone.0257600. eCollection 2021.
The Guidelines for Diagnosis and Treatment of Malaria are meant to guide medical practitioners to enhance optimal management of patients suspected of having malaria which is vital to malarial control and elimination. Medical doctors have the main responsibility for treating patients with malaria so there was need to evaluate the extent to which the medical doctors in Ebonyi state, Nigeria, knew, viewed, and practiced the 2015 National Guidelines for Diagnosis and Treatment of Malaria.
A cross-sectional survey was carried out in May, 2019 among medical doctors who were involved in the management of malaria patients and selected via convenience sampling. Data was collected using a structured self-administered questionnaire. Each respondent was categorized as having poor, fair, or good knowledge, attitude, and practice respectively based on knowledge, attitude, and practice scores of <50%, 50-75%, and >75%. Associated factors were evaluated through bivariate and multivariate binomial logistic regressions at 5% probability of type one error and the overall test for the effect of each independent factor on practice level was done using the "postestimation test" command in Stata.
A total of 156 medical doctors were surveyed. Most, 138 (88.5%) were aware there was a national guideline for diagnosis and treatment of malaria. Among the medical doctors, 19 (12.2%) had good knowledge, 110 (70.5%) had fair knowledge, and 27 (17.3%) had poor knowledge; 38 (24.4%) had good attitude, 74 (47.4%) had fair attitude, and 44 (28.2%) had poor attitude; and 59 (37.8%) had good practice, 90 (57.7%) had fair practice, and 7 (4.5%) had poor practice. The attitude level of the medical doctors toward the 2015 National Guidelines for Diagnosis and Treatment of Malaria was a predictor of good practice (adjusted p-value of overall effect = 0.0003).
Although most of the medical doctors in Ebonyi state, Nigeria, were aware of the existence of a national guideline, only just over a third of them had good practice of the 2015 National Guidelines for Diagnosis and Treatment of Malaria. Policy interventions should focus on improving the attitude of the medical doctors toward the National Guidelines through training and re-training.
《疟疾诊断和治疗指南》旨在指导医务人员加强对疑似疟疾患者的最佳管理，这对疟疾控制和消除至关重要。医生是治疗疟疾患者的主要责任人，因此有必要评估尼日利亚埃邦伊州的医生对 2015 年国家疟疾诊断和治疗指南的了解、看法和实践程度。
2019 年 5 月，采用便利抽样法，对参与疟疾患者管理的医生进行了横断面调查。使用结构化的自我管理式问卷收集数据。根据知识、态度和实践得分<50%、50-75%和>75%，将每个受访者分别归类为知识、态度和实践得分差、中等和良好。通过双变量和多变量二项逻辑回归评估相关因素，置信度为 5%，总体检验用于评估每个独立因素对实践水平的影响，使用 Stata 中的“postestimation test”命令。
共调查了 156 名医生。大多数（138 名，88.5%）医生知道有国家疟疾诊断和治疗指南。在医生中，19 名（12.2%）具有良好的知识，110 名（70.5%）具有中等知识，27 名（17.3%）具有较差的知识；38 名（24.4%）具有良好的态度，74 名（47.4%）具有中等态度，44 名（28.2%）具有较差态度；59 名（37.8%）具有良好的实践，90 名（57.7%）具有中等实践，7 名（4.5%）具有较差实践。医生对 2015 年国家疟疾诊断和治疗指南的态度水平是良好实践的预测因素（整体效果调整后的 p 值=0.0003）。
尽管尼日利亚埃邦伊州的大多数医生都知道国家指南的存在，但只有略多于三分之一的医生能够很好地实施 2015 年国家疟疾诊断和治疗指南。政策干预应通过培训和再培训，重点改善医生对国家指南的态度。
