Direct observation of outpatient management of malaria in a rural Ghanaian district.

摘要: INTRODUCTION: in Ghana, malaria continues to top outpatient morbidities; accounting for about 40% of all attendances. Effective case-management is key its control. We evaluated practices uncomplicated Kwahu South District (KSD) health facilities determine their conformity guidelines. METHODS: we conducted a cross sectional survey at public three randomly selected sub-districts KSD. A non-participatory observation suspected consultations was conducted. Suspected defined as any person with fever (by history or measured axillary temperature > equal 37.5 oC) presenting the between 19th and 29th April 2013. Findings were expressed frequencies, relative mean (± standard deviation) median. RESULTS: 70 clinical observations involving 10 prescribers six facilities, 40 (57.1%) females 16 (22.9%) below five years. Median age 18 years (interquartile range: 5-33). Overall, 63 (90.0%) case-patients had diagnostic tests. Two (3.6%) treated presumptively. All 31 confirmed (33.3%) test negative received Artemisinin-based Combination Therapies (ACTs). However, only 12 (27.9%) 43 ACT Artesunate-Amodiaquine (AA). Only (18.8%) under-fives examined non-malarial causes fever. Mean number drugs per patient 3.7 1.1). 45 (64.3%) patients least one counseling message. CONCLUSION: guidelines KSD suboptimal. Apart from high rate testing use, prescription AA, physical examination needed improvement.