Direct observation of outpatient management of XXXX in a rural ghanaian district.

@entity1 @entity16944 @entity507 @entity506 @entity311 @entity221
INTRODUCTION: In Ghana, @entity311 continues to top outpatient morbidities; accounting for about 40% of all attendances. Effective case-management is key to its control. We evaluated case-management practices of uncomplicated @entity311 in Kwahu South District (KSD) health facilities to determine their conformity to guidelines. METHODS: We conducted a cross sectional survey at all public health facilities in three randomly selected sub-districts in KSD. A non-participatory observation of suspected @entity311 consultations was conducted. Suspected @entity311 was defined as any @entity1 with @entity221 (by history or measured axillary temperature > or equal 37.5 oC) presenting at the selected health facilities between 19th and 29th April 2013. Findings were expressed as frequencies, relative frequencies, mean (   standard deviation) and median. RESULTS: Of 70 clinical observations involving 10 prescribers in six health facilities, 40 (57.1%) were females and 16 (22.9%) were below five years. Median age was 18 years (interquartile range: 5-33). Overall, 63 (90.0%) suspected case- @entity1 had diagnostic tests. Two (3.6%) were treated presumptively. All 31 confirmed and 10 (33.3%) of the test negative case- @entity1 received @entity507 -based Combination Therapies (ACTs). However, only 12 (27.9%) of the 43 case- @entity1 treated with ACT received @entity506 - @entity16944 (AA). Only three (18.8%) of the under-fives were examined for non-malarial causes of @entity221 . Mean number of drugs per @entity1 was 3.7 drugs (   1.1). Only 45 (64.3%) @entity1 received at least one counseling message. CONCLUSION: Conformity of @entity311 case-management practices to guidelines in KSD was suboptimal. Apart from high rate of diagnostic testing and ACT use, prescription of AA, physical examination and counseling needed improvement.
