Factors Influencing Practice Regarding Severe Malaria Among Health Workers in Central Province, Papua New Guinea.

Abstract

Severe malaria is the severe form of malaria which usually leads to significant morbidity, or death if left untreated. Papua New Guinea (PNG) is one country outside sub-African where malaria is heavily endemic, despite the recent positive progresses resulting from intensified control. This study was designed to describe the current practice and investigate factors influencing practice regarding severe malaria among health workers in Central Province, PNG. This was a health facility-based cross-sectional study conducted in May 2018. A total of 142 participants completed self-administered questionnaires for analysis. The dependent variable covered all aspects of case management: overall practice, diagnosis, treatment and follow up in dichotomous outcomes – compliant and non-compliant. Pearson chi-square and Fishers exact test were used to identify associations between independent and dependent variables, and logistic regression was used to control confounders and identify predictors associated with practice regarding severe malaria. Training was lacking, where only 18.3% received some form of training in the last 6 months. Low-moderate knowledge was prevalent in 90% of the participants. Negative attitude to clinical practice was associated with non-compliance in overall practice. High knowledge, positive attitude to responsiveness and favourable cues were associated with following up of discharged severe malaria patients. High perceived benefit was associated with compliance in overall and treatment practices. This study found that high perceived benefits, high knowledge, positive attitude to responsiveness and favourable cues were associated with different aspects of practice regarding severe malaria.