Gloria Ayivi-Vinz^1*, Ghislain E. Sopoh¹, Charles Sossa¹, Chabi Olaniran Alphonse Biaou¹, Abdou-Rahim Ouro-Koura², Michel Makoutodé¹, Edgar-Marius Ouendo¹

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¹ Institut Régional de Santé Publique Comlan Alfred Quenum, Université d’Abomey, Calavi, Bénin.
² Centre de Formation en Santé Publique (CFSP), Lomé, Togo.
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Abstract: Background: Benin republic is a sub-Saharan African country endemic to malaria caused by Plasmodium falciparum. To reduce the death rate due to this scourge, it is essential to ensure quality care, especially for children under five years who are the most vulnerable. The main objective of this study is to assess the quality of severe malaria case management in patients under five years. Methods: Descriptive and analytical cross-sectional study was performed in health facilities in Cotonou city, the economic capital of Benin Republic. Study sample included 205 suspected cases of severe malaria among children aged under five years, in four health facilities. In each of hospitals, all children under five years with severe malaria presumption were enrolled in the study. Quality was assessed through five components: diagnosis, treatment, patient monitoring, counselling/advice, and patient’s follow-up. Based on the Benin Republic’s malaria case management standard protocol, the assessment criteria of each component were defined. Results: The sex ratio was 1.25 boys to a girl. The median of hospitalisation duration was 3 days with first quartile (Q1) = 2 and third quartile (Q3) = 5. Among 205 severe malaria cases included, 157 (76.59%) were not managed in accordance with the requirements of the national protocol of malaria case management. The different components of cases management are not all implemented during the care of patients. Conclusion: There is a need for training to health workers on implementation of severe malaria in children under 5 years protocol. Also, there is a need for investigation about factors associated with malaria protocol implementation.

Keywords: Severe Malaria, Case Management, Protocol Observance, Quality of Care, Benin

Cite this paper: Ayivi-Vinz, G. , Sopoh, G. , Sossa, C. , Biaou, C. , Ouro-Koura, A. , Makoutodé, M. and Ouendo, E. (2020) Quality of Management of Severe Malaria Cases in Children under Five: A Case of Four Health Facilities in the Littoral Department in Benin. Advances in Infectious Diseases, 10, 163-175. doi: 10.4236/aid.2020.104014.

References

[1]   Ministère de la santé (2016) Annuaire des statistiques sanitaires du Bénin année 2015.

[2]   Programme National de Lutte contre le Paludisme (2016) Enquête sur les indicateurs du paludisme au Bénin (MIS 2015).

[3]   Bhatt, S., Weiss, D.J., Cameron, E., et al. (2015) The Effect of Malaria Control on Plasmodium falciparum in Africa between 2000 and 2015. Nature, 526, 207-211.
https://doi.org/10.1038/nature15535

[4]   Programme National de Lutte contre le Paludisme (2014) Plan stratégique de lutte contre le paludisme 2011-2015 révisé avec extension sur 2018. 82.

[5]   Torres, S., Tougher, R.S., Palafox, B., et al. (2009) Evidence for Malaria Medicines Policy a Qualitative Assessment of the Private Sector Antimalarial Distribution Chain in Benin Co-Investigators Principal Investigator.
https://researchonline.lshtm.ac.uk/id/eprint/2869440

[6]   Ministère de la santé, Programme National de Lutte contre le Paludisme (2015) Directives nationales de prise en charge des cas de paludisme. Révisée.

[7]   World Health Organization (2015) Guidelines for the Treatment of Malaria—3rd Edition.
http://www.who.int/malaria

[8]   Yaméogo, T.M., Kyelem, C.G., Ouédraogo, S.M., et al. (2011) Diagnostic et prise en charge du paludisme grave chez l’adulte: Observance des directives nationales au Burkina Faso. Bulletin de la Société de Pathologie Exotique, 104, 284-287.
https://doi.org/10.1007/s13149-010-0129-x

[9]   Steinhardt, L.C., Chinkhumba, J., Wolkon, A., et al. (2014) Quality of Malaria Case Management in Malawi: Results from a Nationally Representative Health Facility Survey. PLoS ONE, 9, e89050.
https://doi.org/10.1371/journal.pone.0089050

[10]   Yaméogo, T.M., Tapsoba, S.P., Sombié, I., et al. (2015) Évaluation de l’application des directives nationales de prise en charge des cas de paludisme au CHU de Bobo-Dioulasso. Sante Publique (Paris), 27, 265-273.
https://doi.org/10.3917/spub.152.0265

[11]   Wilson, M.L. (2012) Malaria Rapid Diagnostic Tests. Clinical Infectious Diseases, 54, 1637-1641.
https://doi.org/10.1093/cid/cis228

[12]   Elechi, H.A., Rabasa, A.I., Bashir, M.F., et al. (2015) Uncomplicated Malaria in Children: The Place of Rapid Diagnostic Test. Nigerian Medical Journal, 56, 85-90.
https://doi.org/10.4103/0300-1652.150686

[13]   Vernelen, K., Barbé, B., Gillet, P., et al. (2018) Photo-Based External Quality Assessment of Malaria Rapid Diagnostic Tests in a Non-Endemic Setting. PLoS ONE, 13, e0201622.

[14]   Rakotoarivelo, R.A., Razakarison, C., Gottot, S., et al. (2012) Évaluation de la prise en charge des cas de fièvre et du paludisme par des médecins communautaires dans les hautes terres centrales de Madagascar, 2009-2010. Médecine et Santé Tropicales, 22, 317-322.

[15]   Ouédraogo, L.T., Drabo, K.M. and Zongo, P.S. (2012) Évaluation de l’application du protocol national de traitement des cas de paludisme simple en milieu rural au Burkina Faso. Sante Publique (Paris), 24, 353-363.
https://doi.org/10.3917/spub.124.0353

[16]   Msangeni, H.A., Kamugisha, M.L., Sembuche, S.H., et al. (2011) Prospective Study on Severe Malaria among In-Patients at Bombo Regional Hospital, Tanga, North-Eastern Tanzania. BMC Infectious Diseases, 11, 256.
https://doi.org/10.1186/1471-2334-11-256

[17]   Djadou, K.E., Takassi, E.O., Guedenon, J.K., et al. (2018) Severe Malaria in Children at Tsevie Hospital (Togo). 2017 International Rural and Elderly Health Informatics Conference, Lome, 13-17 December 2017, 1-4.
https://doi.org/10.1109/IREEHI.2017.8350468

[18]   Makumbe, B., Tshuma, C., Shambira, G., et al. (2017) Evaluation of Severe Malaria Case Management in Mazowe District, Zimbabwe, 2014. The Pan African Medical Journal, 27, 33.
https://doi.org/10.11604/pamj.2017.27.33.11081

[19]   Elmansouf, L., Dubos, F., Dauriac, A., et al. (2011) Évaluation des pratiques dans la prise en charge du paludisme d’importation de l’enfant dans la région Nord-Pas-de-Calais. Médecine et Maladies Infectieuses, 41, 145-151.

[20]   Gbadoé, A.D., Lawson-Evi, K., Badayodi, A., et al. (2006) Paludisme grave de l’enfant: Évaluation de la prise en charge des formes anémiques et neurologiques dans un service de réanimation en milieu tropical. Archives de Pédiatrie, 13, 1554-1555.
https://doi.org/10.1016/j.arcped.2006.09.011

[21]   Raobijaona, H., Randrianotahina, C.H. and Razanamparany, M. (2000) Le paludisme grave de l’enfant observé au Service de Pédiatrie du Centre Hospitalier de Befelatanana à Antananarivo (Madagascar) en 1996-1998. Archives de l’Institut Pasteur de Madagascar, 66, 23-25.

[22]   Olupot-Olupot, P. and Maitland, K. (2013) Management of Severe Malaria: Results from Recent Trials. Advances in Experimental Medicine and Biology, 764, 241-250.

[23]   Crawley, J., Chu, C., Mtove, G., et al. (2010) Malaria in Children. The Lancet (London, England), 375, 1468-1481.
https://doi.org/10.1016/S0140-6736(10)60447-3