Quality of malaria case management at outpatient health facilities in Angola

Malaria Journal

Table 5 Quality of malaria diagnosis in outpatient health facilities, Huambo Province, Angola

Characteristic and patient sub-group	No. and weighted percentage of patients
	n	%	(95% CI)
Health worker's malaria-related diagnosis for the 1 patient with a gold standard diagnosis ^a of complicated malaria
Uncomplicated malaria (major error)	1	100	(NC)
Health workers' malaria-related diagnoses for the 58 patients with a gold standard diagnosis ^a of uncomplicated malaria
Complicated malaria (minor error)	2	2.6	(0-6.4)
Uncomplicated malaria (correct)	32	60.1	(44.5-75.7)
No malaria^b (major error)	24	37.4	(21.6-53.1)
Health workers' malaria-related diagnoses for the 118 patients with a gold standard diagnosis ^a of no malaria
Uncomplicated malaria (minor error)	40	29.9	(17.6-42.2)
No malaria (correct)	78	70.1	(57.8-82.4)
Overall quality of health workers' malaria-related diagnoses among all 177 patients
Correct (health worker diagnoses of malaria and no malaria matched gold standard diagnoses)	110	66.1	(58.3-73.8)
Minor error (health worker incorrectly "over-diagnosed" uncomplicated malaria as complicated malaria, or over-diagnosed no malaria as uncomplicated malaria)	42	20.1	(11.4-28.7)
Major error (health worker incorrectly "under-diagnosed" complicated malaria as uncomplicated malaria, or under-diagnosed uncomplicated malaria as no malaria)	25	13.9	(8.0-19.7)

CI = confidence interval; NC = not calculated.
^a The "gold standard" malaria diagnosis (against which health worker diagnoses were compared) was defined by applying the analysis algorithm (Figure 1) to patient clinical signs and symptoms (assessed by surveyors, but information that should have been available to observed health workers) and laboratory data available to observed health workers (i.e., not the survey team's laboratory results).
^b Health workers' diagnoses of the 24 patients were gastrointestinal illnesses (n = 10; e.g., gastritis, intestinal parasites, and dysentery), respiratory illnesses (n = 5; e.g., bronchitis), skin problems (n = 2; e.g., scabies and skin boils), and other (n = 7; e.g., dental caries, trauma, chicken pox, and malnutrition).

ISSN: 1475-2875