3.9 Métodos de Control y Prueba de los Fluidos de Corte
3.9.9 Calidad del Agua
s TO,
1 2 3 4
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-Medical Centre Lokoja and I<ogi State Specialist Hospital were obtain�d from offices of t he Chi e f Medic , a l Directors in t he tv,o h 't I L' osp1 a s. 1s t s of community health officers (CHOs) and community health e>:tension workers (CHEWs) were obtained from the office of the Head of Department (Health) Lokoja LGA \\-hile the list of p atent m e dicin•! vendors w a s ob t ained fron1 the s e cre ta ry of t he Associa t ion of Pate n t a n d Propri et ary. Medici ne V e ndors (PMV s).
Tl1e t o t al numb e r of healthc a re providers was 914. TJ 1 e proportion of eacl1 cadre in the sampl e frame was de
•t er111ined (by prob2 bility proportional to size,. Then, each
•propor t io n w a s mt1l t iplied by th e s a mple size to deter11 1 in e the actL1al 11t1mber to select fro111 each cadi'e. Tl 1 ereafter, tl1e sa1npling interval, le =N/n was calculated wl1ere N was the 11t1mb,�r of l1ealtl 1 care providers n eacl1 cadre while n was tl1e proportion sa1npled per c2.dre. Tl 1 e first healthcare pr<>vider was selected randomly using a t able of rando111 nun1bers. Tl1en every n th healtltcare provider was selected. A table on the calct1lation is shown below.
Table 3.1 ProJJOrtional allocation of sample size to cadres of healtl1care providers Cadre
Doctors
Phar1nacists Nurses
Commu n ity Health Officers
Community Health Extension \\' orkers Patent Medic;inc
Vendors J otal
•
•
·---�
•
3.5 Data Collection
Semi-structure,j questionnaires were administered by the researcher to healthcare providers to obtain data on their s . d oc10- emograph1c characteristics, knowledge of current guidelines prescription ' . prac ice, tra1n1ng and other factors that may influence t' ..
adherence to gt1idelines on pre · 1· f · scrip ton o ant1malar1als. A copy of the questionnaire is attached (Ai:pendix 1 ).
3.5.1 Questi,)nnai1·e developme11t
Qtiestionnaire was developed with infor111ation obtained from literature search and literature reviews. All qt1estions were asl<cd in E11glisl1 language. Tl1e questions \ve·re pre-tested in I<�ogi LGA of the State. Kogi LGA l1as similar socio-demographic and economic characteristics with Lokoja. T·..venty (20) questionnaires were pre-tested amo11g sa1ne cadres of healthcare providers as the cadres the questionnaires were
intended. Findings dt1ring tl1e pre-test ph�se were 11sed to revise the questionnaires ,vl1ich were later presented to experts (pr,tcticing epidemiologists) for input and face validation before the final copies were prir ted.
3.5.2. Administration of questionnaire
•Questionnaires were administered to re·;pondents by the researcher (interviewer
adm inistered).
3.5.3. Quality control
Data \.i. ere checked for errors, edited and then transferred manually from hard copy I • 51 ·on of questionnaires in Epi Info software. Cl1eck questionnaires to e ectronrc ver
d l I I S ranges and consisten,;y checks were used to ensure only data of co es, ega va uc ,
J tcrcd into the electronic qucstior1naircs. Fe\v p 1c;t J)rcscript1011.
good qua rt} Nere cr1
·d ·re verified by vi5t1al inc;pcctior1 nr1cl c.0111pt1rccJ \\ 1th by thL health
1:arc prov, crs we
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IBADAN LIBRARY
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prescriptions on the questionnaire.
prescriptions on the questionna.
The paSt prescriptions corresponded with
ire
3.6 Data analysis
•Data was analysed using Ep· 1 1 010 so are (version 7.1.1.14) developed by the &:'. ftw
Centers for Disease Control and p reventI•Jn, USA. Frequency tables were used to su1nn1ar1ze anc. present data. Proportions· and percentages were ttsed to describe
categorical variables sucl1 as cadres of respondents, marital statL s and sex of respondents and continuous variable sue� as age of respondents. The lowest age
group (younge�.t respondent) was 18 year�, old vvl 1 ile tl1e oldest respondent was 65 years.
In order to ca�·ry out bivariate analysis, af,e group of respondents and length of time spent in servi,�e by respondents were dichoto1nized using average age of the
respondents as a rough guide. The number of respondents in each group was fairly evenly distributed in each age group category. Bivariate analyses were used to test for associations be·.ween the outcome variable and independent variables. The outcome ,,ariable was adherence to guidelines on prescription of antitnalarials. The independent variables tested dt1ring bivariate analysis were age group, sex, marital status, cadre ar1d years spent in service. Prescription practice of healthcare providers
in relation to severity of malaria, existence of co-morbidities in patients, malaria test results, and pitients· ability to pay for antimalarials . We also tested whether advertisement of antimalarials, availability )f antimalarials, knowledge of prescription guidelines, ease of administration of antmalarials and training on guidelines for
diagnosis and treatment of malaria 1nflue11ccd adherence to prescri1Jtion guiclcli11c�
1:actors tllat were signi fica11t at b1vari Jtc analysis were ft1rtl1er c;t1l1Jcc.rcd tt1 multi variate an�Jysis ( logistic rcgres�ion ).
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Odds ratios were used to measure strength of associations between factors being tested and ac!herence to current gut e mes. Chi-square test was used to test . d 1.
relationship between categorical variables and outcome variable. P-,,alue and 95 o/o confidence interval (9So/o CI) were use to determine statistical significance of d
associations at alpha level of 5%.
3.6.1 Assessment and grading of kno,,,ledge of c111·rent guidelines on diagnosis and treatme11t of malaria
The responde11ts were asl<ed five qt1estions to assess tl1eir l<nowledge of current gt1idelines on prescription of antimalarial3. Tl1e qt1estions covered different sections of ct1rrent guic elines on diagnosis and treatment of malaria. The sections were malaria diagnosis, prevention and treatment. Eac 1 correct answer was scored one mark. · A respondent wl 1 0 a11s\vered three or more questions correctly \Vas g1 aded as having good knowledge while a respondent \\ho answered fewer than three questions correctly was 5raded as having poor knovvledge of current gt1idelines.
The question, asked were name of dru5 for treatment of uncomi:licated malaria, name of recoinmended drug for treatrnent of malaria in pregnancy, name of
d d d J:'.o r treatment of se,,ere malaria, name of twc
1tests used for
recommen e rug 1 1
d I · and name of drug for intermittent preventive
confirmation of suspecte ma aria
•treatment of malaria in pregnancy.
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s,�o
2 3 4
5
Table 3.2 Grading of knowledge f 0 h . ea t care providers on cut·rent I h ·
guidelines for diagnosis and treatment of malaria
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