Case-Management of Malaria in Children Attending an Outpatient Clinic in Southwest Nigeria

This study examined the case-management of malaria in 135 febrile children attending an outpatient clinic in southwest Nigeria. Specifically, we examined the degree of concordance between physician's diagnosis of malaria, maternal perceptions of child febrile illness, and the results of malaria rapid diagnostic tests. The results indicate poor concordance in the diagnosis of malaria by physicians and the results of malaria RDTs (κ = 0.030, p-value = 0.269) as well as between mother's perception of malaria in their children and malaria RDTs (κ = 0.071, p-value = 0.369). While physicians can correctly identify children that have malaria according to the RDT test (Sensitivity = 95.23%), they were poor identifiers of children who do not have malaria (Specificity = 13.15). On the other hand, while mothers are poor identifiers of children that have malaria according to the malaria RDT test (Sensitivity = 38.1%), they are better at identifying children who do not have malaria (Specificity = 71.1%). The findings demonstrate the importance of exploring the contextual factors that influence case management of child malaria in outpatient clinics.