Conformité de la prise en charge du paludisme selon les directives nationales dans deux centres de santé communautaire universitaires urbain et rural au Mali, 2020 à 2021

Abstract

Introduction: National malaria guidelines essentially
recommend the use of artemisinin-based combination
therapies for uncomplicated cases and injectable
artemisinin derivatives for severe cases only after

biological confirmation. The aim of this study was to verify
compliance of management with national guidelines in
University Community Health Centres (CSCom-U) in Mali.
Material and methods: This was a cross-sectional study
conducted in Mali's urban and rural CSCom-Us in Banconi
and Segué respectively from 2020 to 2021. Participants'
medical data were collected from the consultation register
after informed consent. Data analysis was performed
using SPSS 24 software. The chi2 test was used with a
significance level of 5% to compare proportions. Results:
A total of 931 patients were enrolled, including 500 in
Segué. For 98 cases of uncomplicated malaria in Banconi,
71.4% were biologically confirmed, and for 46 cases of
severe malaria, 82.6% tested positive. In Ségué, for 163
cases of uncomplicated malaria, 95.7% were biologically
confirmed, and for 141 cases of severe malaria, 100%
were confirmed. Management complied with national
guidelines in 51% of cases in Banconi and 92% of cases
in Ségué for simple malaria, and 71.7% and 95.7%
respectively for severe malaria. Conclusion: National
guidelines for malaria diagnosis and treatment were better
adhered to in rural areas than in urban areas.