Guidelines and mindlines: why do clinical staff over-diagnose malaria in Tanzania? A qualitative study

Clare Chandler1, Caroline Jones1, Gloria Boniface2, Kaseem Juma2, Hugh Reyburn2, Christopher J M Whitty1
1London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT London, UK
2Joint Malaria Programme, Kilimanjaro Christian Medical Centre, P.O.BOX 2228, Moshi, Tanzania

Tóm tắt

Từ khóa


Tài liệu tham khảo

English M, Esamai F, Wasunna A, Were F, Ogutu B, Wamae A, Snow RW, Peshu N: Assessment of inpatient paediatric care in first referral level hospitals in 13 districts in Kenya. Lancet. 2004, 363 (9425): 1948-1953. 10.1016/S0140-6736(04)16408-8.

Barat L, Chipipa J, Kolczak M, Sukwa T: Does the availability of blood slide microscopy for malaria at health centers improve the management of persons with fever in Zambia?. Am J Trop Med Hyg. 1999, 60 (6): 1024-1030.

Van Dillen J, De Jager AJ, De Jong I, Wendte JF: Overdiagnosis of malaria in hospitalized patients in Namibia. Trop Doct. 2007, 37 (3): 185-186. 10.1258/004947507781524845.

Reyburn H, Mbatia R, Drakeley C, Carneiro I, Mwakasungula E, Mwerinde O, Saganda K, Shao J, Kitua A, Olomi R, Greenwood BM, Whitty CJ: Overdiagnosis of malaria in patients with severe febrile illness in Tanzania: a prospective study. BMJ. 2004, 329 (7476): 1212-10.1136/bmj.38251.658229.55.

Berkley JA, Lowe BS, Mwangi I, Williams T, Bauni E, Mwarumba S, Ngetsa C, Slack MP, Njenga S, Hart CA, Maitland K, English M, Marsh K, Scott JA: Bacteremia among children admitted to a rural hospital in Kenya. N Engl J Med. 2005, 352 (1): 39-47. 10.1056/NEJMoa040275.

Amexo M, Tolhurst R, Barnish G, Bates I: Malaria misdiagnosis: effects on the poor and vulnerable. Lancet. 2004, 364 (9448): 1896-1898. 10.1016/S0140-6736(04)17446-1.

Wiseman V, Kim M, Mutabingwa TK, Whitty CJ: Cost-Effectiveness Study of Three Antimalarial Drug Combinations in Tanzania. PLoS Med. 2006, 3 (10):

Chandramohan D, Jaffar S, Greenwood B: Use of clinical algorithms for diagnosing malaria. Trop Med Int Health. 2002, 7 (1): 45-52. 10.1046/j.1365-3156.2002.00827.x.

Tanzania Ministry of Health : National Guidelines for malaria diagnosis and treatment. Malaria Control series 11. 2006, National Malraia Control Programme, Dar es Salaam

Njama-Meya D, Clark TD, Nzarubara B, Staedke S, Kamya MR, Dorsey G: Treatment of malaria restricted to laboratory-confirmed cases: a prospective cohort study in Ugandan children. Malar J. 2007, 6: 7-10.1186/1475-2875-6-7.

Reyburn H, Mbakilwa H, Mwangi R, Mwerinde O, Olomi R, Drakeley C, Whitty CJ: Rapid diagnostic tests compared with malaria microscopy for guiding outpatient treatment of febrile illness in Tanzania: randomised trial. Bmj. 2007, 334 (7590): 403-10.1136/bmj.39073.496829.AE.

Hamer DH, Ndhlovu M, Zurovac D, Fox M, Yeboah-Antwi K, Chanda P, Sipilinyambe N, Simon JL, Snow RW: Improved diagnostic testing and malaria treatment practices in Zambia. JAMA. 2007, 297 (20): 2227-2231. 10.1001/jama.297.20.2227.

Rowe AK, Hamel MJ, Flanders WD, Doutizanga R, Ndoyo J, Deming MS: Predictors of correct treatment of children with fever seen at outpatient health facilities in the Central African Republic. Am J Epidemiol. 2000, 151 (10): 1029-1035.

Osterholt DM, Rowe AK, Hamel MJ, Flanders WD, Mkandala C, Marum LH, Kaimila N: Predictors of treatment error for children with uncomplicated malaria seen as outpatients in Blantyre district, Malawi. Trop Med Int Health. 2006, 11 (8): 1147-1156. 10.1111/j.1365-3156.2006.01666.x.

Howie JG: Clinical judgement and antibiotic use in general practice. Br Med J. 1976, 2 (6043): 1061-1064.

Stimson GV, Webb B: Going to See the Doctor: the Consultation Process in General Practice. 1975, London , Routledge & Kegan Paul

WHO: Interventions and strategies to improve the use of antimicrobials in developing countries. 2001, World Health Organisation. Drug Management Program

Rowe AK, de Savigny D, Lanata CF, Victora CG: How can we achieve and maintain high-quality performance of health workers in low-resource settings?. Lancet. 2005, 366 (9490): 1026-1035. 10.1016/S0140-6736(05)67028-6.

van der Geest S, Finkler K: Hospital ethnography: introduction. Soc Sci Med. 2004, 59 (10): 1995-2001. 10.1016/j.socscimed.2004.03.004.

Andersen HM: "Villagers": differential treatment in a Ghanaian hospital. Soc Sci Med. 2004, 59 (10): 2003-2012. 10.1016/j.socscimed.2004.03.005.

Zaman S: Poverty and violence, frustration and inventiveness: hospital ward life in Bangladesh. Soc Sci Med. 2004, 59 (10): 2025-2036. 10.1016/j.socscimed.2004.03.007.

Yoder PS: Negotiating relevance: belief, knowledge, and practice in international health projects. Med Anthropol Q. 1997, 11 (2): 131-146. 10.1525/maq.1997.11.2.131.

Paredes P, de la Pena M, Flores-Guerra E, Diaz J, Trostle J: Factors influencing physicians' prescribing behaviour in the treatment of childhood diarrhoea: knowledge may not be the clue. Soc Sci Med. 1996, 42 (8): 1141-1153. 10.1016/0277-9536(95)00387-8.

Howteerakul N, Higginbotham N, Freeman S, Dibley MJ: ORS is never enough: physician rationales for altering standard treatment guidelines when managing childhood diarrhoea in Thailand. Soc Sci Med. 2003, 57 (6): 1031-1044. 10.1016/S0277-9536(02)00478-1.

Grol R: Personal paper. Beliefs and evidence in changing clinical practice. BMJ. 1997, 315 (7105): 418-421.

Drakeley CJ, Carneiro I, Reyburn H, Malima R, Lusingu JP, Cox J, Theander TG, Nkya WM, Lemnge MM, Riley EM: Altitude-dependent and -independent variations in Plasmodium falciparum prevalence in northeastern Tanzania. J Infect Dis. 2005, 191 (10): 1589-1598. 10.1086/429669.

Tanzania Ministry of Health : HIV/AIDS/STI Surveillance Report. January - December 2004. Report Number 19. 2005, Dar es Salaam , National AIDS Control Programme

World Health Organisation : Hospital Care for Children. Guidelines for the management of common illnesses with limited resources. 2005, Geneva , WHO Press

Rowe AK, Lama M, Onikpo F, Deming MS: Health worker perceptions of how being observed influences their practices during consultations with ill children. Trop Doct. 2002, 32 (3): 166-167.

Leonard K, Masatu MC: Outpatient process quality evaluation and the Hawthorne Effect. Soc Sci Med. 2006, 63 (9): 2330-2340. 10.1016/j.socscimed.2006.06.003.

Strauss AL: Qualitative analysis for social scientists. 1987, Cambridge , Cambridge University Press

Gabbay J, le May A: Evidence based guidelines or collectively constructed "mindlines?" Ethnographic study of knowledge management in primary care. BMJ. 2004, 329 (7473): 1013-10.1136/bmj.329.7473.1013.

Pariyo GW, Gouws E, Bryce J, Burnham G: Improving facility-based care for sick children in Uganda: training is not enough. Health Policy Plan. 2005, 20 Suppl 1: i58-i68. 10.1093/heapol/czi051.

Ofori-Adjei D, Arhinful DK: Effect of training on the clinical management of malaria by medical assistants in Ghana. Soc Sci Med. 1996, 42 (8): 1169-1176. 10.1016/0277-9536(95)00389-4.

Mathauer I, Imhoff I: Health worker motivation in Africa: the role of non-financial incentives and human resource management tools. Hum Resour Health. 2006, 4: 24-10.1186/1478-4491-4-24.

Aitken JM: Voices from the inside: managing district health services in Nepal. Int J Health Plann Manage. 1994, 9 (4): 309-340. 10.1002/hpm.4740090405.

Sararaks S, Jamaluddin R: Demotivating factors among government doctors in Negeri Sembilan. Med J Malaysia. 1999, 54 (3): 310-319.

Franco LM, Bennett S, Kanfer R: Health sector reform and public sector health worker motivation: a conceptual framework. Soc Sci Med. 2002, 54 (8): 1255-1266. 10.1016/S0277-9536(01)00094-6.

Gilson L, Palmer N, Schneider H: Trust and health worker performance: exploring a conceptual framework using South African evidence. Soc Sci Med. 2005, 61 (7): 1418-1429. 10.1016/j.socscimed.2004.11.062.

Manzi F, Kida T, Mbuyita S, Palmer N, Gilson L: Exploring the Influence of Workpace Trust over Health Worker Performance. Preliminary National Overview Report: Tanzania. Prepared for the Health Economics and Financing Programme, London School of Hygiene and Tropical Medicine. 2004, [ http://www.lshtm.ac.uk/hpu/hefp ]

Nizami SQ, Khan IA, Bhutta ZA: Drug prescribing practices of general practitioners and paediatricians for childhood diarrhoea in Karachi, Pakistan. Soc Sci Med. 1996, 42 (8): 1133-1139. 10.1016/0277-9536(95)00386-X.

Chandler CIR, Mwangi R, Mbakilwa H, Olomi R, Whitty CJ, Reyburn H: Malaria overdiagnosis: is patient pressure the problem?. Health Policy and Planning. 2008

Britten N, Ukoumunne O: The influence of patients' hopes of receiving a prescription on doctors' perceptions and the decision to prescribe: a questionnaire survey. BMJ. 1997, 315 (7121): 1506-1510.

Mangione-Smith R, McGlynn EA, Elliott MN, Krogstad P, Brook RH: The relationship between perceived parental expectations and pediatrician antimicrobial prescribing behavior. Pediatrics. 1999, 103 (4 Pt 1): 711-718. 10.1542/peds.103.4.711.

Karras DJ, Ong S, Moran GJ, Nakase J, Kuehnert MJ, Jarvis WR, Talan DA: Antibiotic use for emergency department patients with acute diarrhea: Prescribing practices, patient expectations, and patient satisfaction. Ann Emerg Med. 2003, 42 (6): 835-842. 10.1016/S0196-0644(03)00602-4.

Mwangi R: Malaria: The acceptable disease in Tanzania. id21 insights health. 2006, 9: [ http://www.id21.org/insights/insights-h09/index.html ]

Hadiyono JE, Suryawati S, Danu SS, Sunartono, Santoso B: Interactional group discussion: results of a controlled trial using a behavioral intervention to reduce the use of injections in public health facilities. Soc Sci Med. 1996, 42 (8): 1177-1183. 10.1016/0277-9536(95)00391-6.

Bradley CP: Factors which influence the decision whether or not to prescribe: the dilemma facing general practitioners. Br J Gen Pract. 1992, 42 (364): 454-458.

Armstrong D, Reyburn H, Jones R: A study of general practitioners' reasons for changing their prescribing behaviour. BMJ. 1996, 312 (7036): 949-952.

Bandura A: Self-efficacy. The exercise of control. 1997, New York , WH Freeman, 3rd

Lagerlov P, Loeb M, Andrew M, Hjortdahl P: Improving doctors' prescribing behaviour through reflection on guidelines and prescription feedback: a randomised controlled study. Qual Health Care. 2000, 9 (3): 159-165. 10.1136/qhc.9.3.159.

Perez-Cuevas R, Guiscafre H, Munoz O, Reyes H, Tome P, Libreros V, Gutierrez G: Improving physician prescribing patterns to treat rhinopharyngitis. Intervention strategies in two health systems of Mexico. Soc Sci Med. 1996, 42 (8): 1185-1194. 10.1016/0277-9536(95)00398-3.

Veninga CC, Denig P, Zwaagstra R, Haaijer-Ruskamp FM: Improving drug treatment in general practice. J Clin Epidemiol. 2000, 53 (7): 762-772. 10.1016/S0895-4356(00)00194-3.

D'Acremont V, Lengeler C, Genton B: Stop ambiguous messages on malaria diagnosis. BMJ. 2007, 334 (7592): 489-10.1136/bmj.39143.024838.1F.

Gwer S, Newton CR, Berkley JA: Over-diagnosis and co-morbidity of severe malaria in African children: a guide for clinicians. Am J Trop Med Hyg. 2007, 77 (6 Suppl): 6-13.

Thomson R, Lavender M, Madhok R: How to ensure that guidelines are effective. BMJ. 1995, 311 (6999): 237-242.

Rowe AK, Onikpo F, Lama M, Deming MS: Risk and protective factors for two types of error in the treatment of children with fever at outpatient health facilities in Benin. Int J Epidemiol. 2003, 32 (2): 296-303. 10.1093/ije/dyg063.

Davis DA, Thomson MA, Oxman AD, Haynes RB: Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA. 1995, 274 (9): 700-705. 10.1001/jama.274.9.700.

Ross-Degnan D, Laing R, Santoso B, Ofori-Adjei D, Lamoureux C, Hogerzeil H: Improving pharmaceutical use in primary care in developing counties: a critical review of experience and lack of experience. Presented at the International Conference on Improving Use of Medicines. 1997, Chiang Mai, Thailand, April

Brown PJ: Malaria, miseria, and underpopulation in Sardinia: the "malaria blocks development" cultural model. Med Anthropol. 1997, 17 (3): 239-254.

Brent AJ, Oundo JO, Mwangi I, Ochola L, Lowe B, Berkley JA: Salmonella bacteremia in Kenyan children. Pediatr Infect Dis J. 2006, 25 (3): 230-236. 10.1097/01.inf.0000202066.02212.ff.