Assessment of doctors' management of severe malaria in urban centres in Eastern Nigeria.

Abstract

Malaria remains a heavy burden in sub-saharan Africa and accounts for over one million deaths per annum. Prompt and appropriate management of severe cases is critical in both disease control and reduction in mortality. This study explores the management actions of doctors in urban settings in Nigeria. A survey of medical practitioners in four urban local government areas (LGAs) in two states in South- Eastern Nigeria was conducted. Using simple random sampling technique, sixty doctors were chosen in each of the four LGAs giving a total of two hundred and forty. They were interviewed on their management actions for children with severe malaria. The mean age of the doctors was 34.6 years. 83.5% (167) of them were males while 16.5% (33) were females. 65.5% (131) of the doctors attend to children regularly. The common features of severe malaria seen include; high fever 52.7% (69), persistent vomiting 27.5% (36), severe anaemia 24.4% (32), refusal of drinks 7.6% (10), convulsion 7.6% (10), loss of consciousness 4.6% (6) and respiratory distress 2.3% (3). 79.4% (104/131) of the doctors that see children regularly have diagnosed cerebral malaria in the last five years. Quinine is the drug of choice for the treatment of cerebral malaria 87.8% (115/ 131). 56.5% (74/131) of the practitioners see patients with severe anaemia requiring blood transfusion on a monthly basis. The monthly mean of such anaemic patient per physician is 6.7 patients. The median time for blood transfusion from time of request to onset ot transfusion is 3 — 4 hours. The current state ot health facilities and personnel is not meeting up with the malaria challenge. Urgent efforts need to be made to curb the scourge