BACKGROUND Presumptive diagnosis and prescription of anti-malarial medicines to malaria rapid diagnostic test (RDT)-negative patients is a common practice among health care workers (HCWs) in Nigeria. There is paucity of data on HCWs adherence to RDT result in Sokoto metropolis, Nigeria. The study was conducted to determine HCWs adherence to malaria test result and the influencing factors. METHODS A cross-sectional study was conducted among 262 HCWs selected by multistage sampling technique from primary and secondary health facilities in Sokoto metropolis. Data on demographic characteristics, adherence to RDT result and its influencing factors were collected from the HCWs. Adherence was categorized into good if adherence score is ≥ 4 and poor if otherwise. Chi-squared test was used to test association between adherence to test results and patients' fever presentation, expectation to be given anti-malarials, prior HCWs' case management training, among others. Independent predictors of adherence to RDT results were ascertained. RESULTS Respondents' mean age was 33.5 ± 7.9 years, 190 (72.5%) worked in Primary Health Care facilities, 112 (42.8%) were Community Health Workers, 178 (67.9%) had National Diploma Certificate. The median years of practice was 5.0 (IQR: 3-10) years, while 118 (45.0%) had at most 4 years of practice. Overall, 211 (80.5%) had good adherence to RDT results. About 108 (89.3%) of HCWs who had training on malaria case management and 35 (89.7%) certificate holders had good adherence to RDT results. Predictors of adherence to test results were presence of fever in the patient [adjusted odds ratio (aOR): 2.53, 95% confidence interval (CI) 1.18-5.43], patients' expectation to be given anti-malarial medicines by the HCW (aOR: 3.06, 95% CI 1.42-6.58) and having been trained on malaria case management (aOR: 2.63; 95% CI 1.26-5.44). CONCLUSION High level of adherence to RDT results among HCWs in Sokoto metropolis could be attributed to prior malaria case management training and HCWs' confidence in the national treatment guidelines. Continual training and supportive supervision of HCWs on malaria case management might optimize the current level of adherence to RDT results in Sokoto metropolis, Nigeria. Similarly, patients/caregivers' health education could aid better understanding of the need for anti-malarials thus reducing unnecessary demand.

中文翻译：

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尼日利亚索科托都市的医护人员遵守疟疾快速诊断测试结果。

背景技术对尼日利亚的疟疾快速诊断测验（RDT）阴性患者进行抗疟疾药物的推定性诊断和处方是尼日利亚卫生保健工作者（HCW）的普遍做法。在尼日利亚的索科托市，关于医务工作者遵守RDT结果的数据很少。该研究旨在确定医护人员对疟疾检测结果的依从性及其影响因素。方法采用多阶段抽样技术从索科托市一级和二级卫生机构选择的262名HCW中进行了横断面研究。从医务工作者收集有关人口统计学特征，对RDT结果的依从性及其影响因素的数据。如果依从性得分≥4，则依从性被分类为良好，否则被分类为差。卡方检验用于检验对检验结果的依从性与患者发烧表现，期望给予抗疟药，先前的医护人员进行病例管理培训之间的关联。确定了遵守RDT结果的独立预测因素。结果受访者的平均年龄为33.5±7.9岁，在初级卫生保健机构工作的有190名（72.5％），在社区卫生工作者中工作的有112名（42.8％），拥有国家文凭证书的有178名（67.9％）。中位执业年限为5.0（IQR：3-10）年，而最长执业4年为118（45.0％）。总体而言，211（80.5％）对RDT结果具有良好的依从性。约有108名（89.3％）接受了疟疾病例管理培训的医务工作者和35名（89.7％）证书持有者对RDT结果有良好的依从性。坚持检测结果的预测指标是患者发烧[校正比值比（aOR）：2.53，95％置信区间（CI）1.18-5.43]，患者期望通过HCW给予抗疟药（aOR ：3.06，95％CI 1.42-6.58），并接受过疟疾病例管理培训（aOR：2.63； 95％CI 1.26-5.44）。结论索科托大都市的医护人员对RDT结果的高度依从性可能归因于先前的疟疾病例管理培训以及医护人员对国家治疗指南的信心。继续对HCW进行有关疟疾病例管理的培训和支持性监督，可以使尼日利亚Sokoto大都市目前对RDT结果的依从性达到最佳水平。同样，患者/护理人员