KNOWLEDGE, ATTITUDE AND MANAGEMENT PRACTICES RELATING TO MALARIA AMONG PRIMARY HEALTHCARE WORKERS IN IDO LOCAL GOVERNMENT AREA, OYO STATE, NIGERIA

Abstract

Malaria is a serious public health problem in Nigeria and Primary Health Care (PHC) workers have important roles to play in its control. The new anti-malaria policy expects healthcare providers at PHC level to treat uncomplicated malaria with Artemisinin Combination Therapy (ACT). Understanding gaps in knowledge, attitude and management practices relating to uncomplicated malaria among PHC workers is imperative in designing effective intervention strategies for improved management of the disease. This study was designed to investigate knowledge, attitude and management practices of PHC workers relating to malaria in Ido Local Government Area of Oyo State, Nigeria. A cross-sectional survey was adopted. All available PHC workers (112) who consented to participate in the study were interviewed using a validated semi-structured interviewer administered questionnaire. The questionnaire was used to obtain data on the workers’ demographic characteristics, knowledge, attitude and malaria management practices. The questionnaire consisted of a 30-point knowledge scale which was graded as 0-10 (poor), 11-20(fair) and 21-30 (good). Furthermore, the questionnaire assessed workers’ attitude and this was graded as negative (0 -11) or positive (>11-24). Data were analysed using descriptive statistics, t-test and ANOVA; p ≤ 0.05. Respondents’ age was 39.5±8.5 years, 80.4% were females, 92.0% married, 81.3% Christians and majority (63.4%) had Diploma in Health Technology. A larger percentage of respondents were community health extension workers (57.1%) and nurses (12.5%). Over half (54.5%) were unaware of the national treatment guideline for Malaria. Also, 52.7% had never attended a training session on the new malaria treatment guideline in the last five years. The knowledge score of respondents was 17.3±3.2 and most (82.2%) had fair knowledge. The attitudinal score was 16.3±4.1 and most (89.3%) had a positive attitude towards the use of ACTs in the treatment of malaria. Almost all (98.2%) agreed that ACTs was the most effective medicines for treating malaria. Only 5.4% asked about previous use of medications from clients preceeding the visit for treatment. About half (47.5%) diagnosed malaria by asking clients questions about fever, 45.5% by taking temperature and 14.2% by testing malaria parasite. Most (95.5%) prescribed ACT as a first line of treatment drug in treating malaria with Artemether-Lumefantrine (AL) being the type mostly prescribed (88.7%). However, inappropriate treatment practices included prescription of Sulphadoxine Pyrimethamine (13.4%) and Chloroquine (2.7%) to clients. About half 49.9% and 46.9% respondents correctly prescribed age-appropriate dosages of AL to under-fives with uncomplicated malaria in the two weight categories (5-14kg and 15-25kg respectively). Differences in mean knowledge scores were not significant in all the categories of respondents’ demographics. Majority of the health workers in Ido Local Government Area had a positive attitude towards the use of Artemisinin Combination Therapy in managing uncomplicated malaria. However, respondents’ knowledge was fair and management practices was poor. There is a need for this group of health workers to undergo periodic in-service training.