Diagnosis of malaria by community health workers in Nigeria.
OBJECTIVE
The introduction of primary health care made Nigeria, a developing country, train and retrain community health workers to work all over the country especially in the rural communities where there is dearth of doctors. Despite their training and experience many people are skeptical of their competence to diagnose accurately what more treating endemic disease like malaria. The need to find out the diagnostic competence of the health workers in malaria control programme now in Nigeria necessitated this study.


METHODS
A rural primary health centre, the sentinel site for malarial control programme investigation in Imo State of Nigeria was selected. The community health technician (CHT) was the health worker in charge. Those who were diagnosed as malaria patients by CHT were examined by a medical laboratory scientist (who was engaged specifically for this job) for malaria parasitaemia. The laboratory examination was Giamsa - stained thick blood from fingerprint. Those with positive parasite density count at 1000/microL and above were regarded as malaria patients. The study was from March - October 2007.


RESULTS
The number diagnosed as malaria patients on clinical grounds by CHT was 2512 while the number diagnosed by both clinical and laboratory basis was 2490. The number of patients with wrong diagnosis of malaria by CHT was 22 (0.875%).


CONCLUSIONS
The CHT is useful in the diagnosis and by extension in the control of such endemic disease as malaria where there is no laboratory facilities. Both the employers and populace should repose confidence in their services and in the area where they have been trained and acquired experience
Eke
R A
RA
Department of Community Medicine & Public Health Care, College of Medicine Abia State University, Aba, Nigeria. demregi@yahoo.com
Enwereji
E E
EE
D002983:Clinical Competence; D003150:Community Health Workers / Q000193:education / Q000592:standards*; D005260:Female; D006280:Health Workforce; D006801:Humans; D008288:Malaria / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D009549:Nigeria; D018512:Parasitemia / Q000175:diagnosis* / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D010961:Plasmodium / Q000302:isolation & purification*; D011320:Primary Health Care; D011933:Reagent Kits, Diagnostic; D019035:Rural Health Services
D011933:Reagent Kits, Diagnostic