Experiences of healthcare personnel on the efficacy of artemisinin-based combination therapies and malaria diagnosis in hospitals in Uganda

Abstract Background The risk of widespread resistance to artemisinin-based combination therapies (ACTs) remains high in Uganda following detection of Plasmodium falciparum parasites with delayed Artemisinin clearance genotype and phenotype. Establishment of context specific interventions to mitigate emergence and spread of artemisinin resistance is thus key in the fight against malaria in the country. The aim of this study was to explore the experiences of healthcare personnel on malaria diagnosis and self-reported efficacy of ACTs in management of malaria symptomatic patients in hospitals in low and high malaria transmission settings in Uganda. Methods This was a qualitative study in which data was collected from healthcare personnel in hospitals using key informant interviews. The key informant interview guide was developed, pre-test prior to use and covered the following areas, (i) sociodemographic characteristics, (ii) malaria diagnosis (clinical and parasite based), (iii) quality assured artemisinin-based combination therapy, (iv) malaria patient follow-up, (v) artemisinin resistance, (vi) antimalarial self-medication. Data was entered in Atlas.ti ver 9.0 and analysis done following a framework criterion. Results A total of 22 respondents were interviewed of which 16 (72.7%) were clinicians. Majority, 81.8% (18/22) of the respondents were male. The following themes were developed from the analysis, malaria diagnosis (procedures and challenges), use of malaria laboratory test results, malaria treatment in hospitals, use of quality assured ACTs (QAACTs) in malaria treatment, and efficacy of ACTs in malaria treatment. Conclusion Most healthcare personnel-initiated malaria treatment after a positive laboratory test. Malaria patients who report remaining symptomatic after taking a full course of ACTs are common especially in high malaria transmission settings in Uganda. There is need for regular monitoring of artemisinin resistance emergence and spread in the country.