Resumo

LECCA G, Leonid; LLANOS-ZAVALAGA, Fernando  e  HUAYTA Z, Ernesto. Criterios clínicos y epidemiológicos de los prestadores para el diagnóstico presuntivo y elección de tratamiento en paciente con Malaria, Piura - Perú, 2000. Rev. perú. med. exp. salud publica [online]. 2002, vol.19, n.2, pp.68-73. ISSN 1726-4634.

Objective: To know the criteria for diagnostic suspicion and treatment selection in health facilities lacking equipment for inmediate diagnosis of malaria. Materials and methods: A qualitative study was carried out in March 2000 in the department of Piura, Peru. The key informants were health care workers (HCWs) responsible of out patient care, randomly selected from two groups (high and medium endemicity); 12 in-depth interviews were carried out, one for each site, using the saturation principle. Basedon the interviews a map of knowledge was developed. Results: The health care providers used clinical and epidemiological criteria for their diagnostic suspicion. For the clinical approach they considered three symptoms (headache, fever and chills), and associated the higher intensity in symptoms with malaria falciparum. In turn, they described difficulties for differentiating malaria from other clinical conditions. The epidemiologic approach was influenced by the geographical origin and prevalence of Plasmodium species, the seasonality of the illness and population practices (agricultural activity, migration and absence of preventive practices). Meanwhile, factors that influence treatment selection were: the diagnostic suspicion, the normative approach (guidelines of the Ministry of Health), and the degree of competence of HCWs. Conclusions: The aforementioned approaches are insufficient to define malaria suspicion, and it is necessary to implementate methods for rapid diagnosis, in order to have an appropriate and timely treatment. Also, it is necessary to train permanently continuously health care workers in the diverse aspects of malaria.

Palavras-chave : Malaria/diagnostic; Malaria/epidemiology; Malaria/therapy; Health centers; Health personnel; Peru.

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