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Simulated Malaria Online Tool: An Instrument for Evaluating Healthcare Providers' Practices and Contributing to the Evidence Base for Certifying Malaria Elimination and Preventing Its Re-Establishment Publisher Pubmed



Majdzadeh R1 ; Mansournia MA2 ; Ahmadi A3 ; Raeisi A4 ; Azizi H5
Authors
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Authors Affiliations
  1. 1. School of Health and Social Care, University of Essex, Colchester, United Kingdom
  2. 2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. National Programme Manager for Malaria Elimination, Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

Source: Malaria Journal Published:2024


Abstract

Background: Healthcare providers (HCPs) practice and correct management of suspected malaria (CMSM) are central components of malaria elimination and prevention of re-establishment (POR) in countries in the elimination phase. However, knowledge of malaria surveillance systems and HCPs practices often wanes in countries aiming to eliminate malaria due to the low numbers of cases. The study aimed to implement a valid Simulated Malaria Online Tool (SMOT) for assessment HCP performance in CMSM and POR in a malaria-free area. Methods: HCPs were evaluated using SMOT tool based on four criteria including presenting a suspected malaria case for detection of HCPs’ failures in recognition (a), diagnosis (b), appropriate treatment (c), and urgent reporting (d); and compared with simulated patients (SP). Multiple logistic regression analysis was carried out to estimate adjusted odds ratios (ORs) for the risk of HCPs failures. Results: The overall failure proportion was 237 (83%), and the majority of failures were in recognition (a). There was no significant difference between the SMOT and SP based on all failure criteria (P > 0.05). The private clinic (93%) and the public specialized clinic (70%) had the highest and lowest failure proportions. After passing the recognition stage (a), the overall failure proportions decreased to 47.8% and 25.0% for total HCPs and infectious disease specialists, respectively. In the final analysis, private sector (AOR = 4.36: 1.25–15.2), not-specialist providers (AOR = 2.84: 1.29–6.25) and HCPs with ≥ 5 years’ experience (AOR = 2.03: 1.01–6.25) increased the risk of failure. Conclusion: Findings confirmed the implementation of SMOT tool in settings where malaria transmission is low or interrupted. The tool is able to identify sub-groups of providers needing strengthening, and contributes to the prevention of malaria re-establishment. © The Author(s) 2024.
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Experts (# of related papers)
Ayat Ahmadi Saraeilani (2)
Mohammad Ali Mansournia (2)