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Experience and confidence in health technologies: evidence from malaria testing and treatment in Western Kenya.

Publication ,  Journal Article
Mangeni, JN; Abel, L; Taylor, SM; Obala, A; O'Meara, WP; Saran, I
Published in: BMC Public Health
September 6, 2022

BACKGROUND: Low adoption of effective health technologies increases illness morbidity and mortality worldwide. In the case of malaria, effective tools such as malaria rapid diagnostic tests (RDTs) and artemisinin-combination therapies (ACTs) are both under-used and used inappropriately. Individuals' confidence in RDTs and ACTs likely affects the uptake of these tools. METHODS: In a cohort of 36 households (280 individuals) in Western Kenya observed for 30 months starting in June 2017, we examined if experience with RDTs and ACTs changes people's beliefs about these technologies and how those beliefs affect treatment behavior. Household members requested a free RDT from the study team any time they suspected a malaria illness, and positive RDT results were treated with a free ACT. We conducted annual, monthly, and sick visit surveys to elicit beliefs about the accuracy of malaria RDT results and the effectiveness of ACTs. Beliefs were elicited on a 5-point Likert scale from "very unlikely" to "very likely." RESULTS: Over the study period, the percentage of survey respondents that said a hypothetical negative RDT result was "very likely" to be correct increased from approximately 55% to 75%. Controlling for initial beliefs, people who had been tested at least once with an RDT in the past year had 3.6 times higher odds (95% CI [1 1.718 7.679], P = 0.001) of saying a negative RDT was "very likely" to be correct. Confidence in testing was associated with treatment behavior: those who believed a negative RDT was "very likely" to be correct had 1.78 times higher odds (95% CI [1.079 2.934], P = 0.024) of adhering to a negative RDT result (by not taking ACTs) than those who were less certain about the accuracy of negative RDTs. Adherence to a negative test also affected subsequent beliefs: controlling for prior beliefs, those who had adhered to their previous test result had approximately twice the odds (OR = 2.19, 95% CI [1.661 2.904], P < 0.001) of saying that a hypothetical negative RDT was "very likely" to be correct compared to those who had not adhered. CONCLUSIONS: Our results suggest that greater experience with RDTs can not only increase people's confidence in their accuracy but also improve adherence to the test result.

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Published In

BMC Public Health

DOI

EISSN

1471-2458

Publication Date

September 6, 2022

Volume

22

Issue

1

Start / End Page

1689

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Public Health
  • Malaria
  • Kenya
  • Humans
  • Family Characteristics
  • Diagnostic Tests, Routine
  • Biomedical Technology
  • 4206 Public health
  • 4203 Health services and systems
 

Citation

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Mangeni, J. N., Abel, L., Taylor, S. M., Obala, A., O’Meara, W. P., & Saran, I. (2022). Experience and confidence in health technologies: evidence from malaria testing and treatment in Western Kenya. BMC Public Health, 22(1), 1689. https://doi.org/10.1186/s12889-022-14102-y
Mangeni, Judith N., Lucy Abel, Steve M. Taylor, Andrew Obala, Wendy Prudhomme O’Meara, and Indrani Saran. “Experience and confidence in health technologies: evidence from malaria testing and treatment in Western Kenya.BMC Public Health 22, no. 1 (September 6, 2022): 1689. https://doi.org/10.1186/s12889-022-14102-y.
Mangeni JN, Abel L, Taylor SM, Obala A, O’Meara WP, Saran I. Experience and confidence in health technologies: evidence from malaria testing and treatment in Western Kenya. BMC Public Health. 2022 Sep 6;22(1):1689.
Mangeni, Judith N., et al. “Experience and confidence in health technologies: evidence from malaria testing and treatment in Western Kenya.BMC Public Health, vol. 22, no. 1, Sept. 2022, p. 1689. Pubmed, doi:10.1186/s12889-022-14102-y.
Mangeni JN, Abel L, Taylor SM, Obala A, O’Meara WP, Saran I. Experience and confidence in health technologies: evidence from malaria testing and treatment in Western Kenya. BMC Public Health. 2022 Sep 6;22(1):1689.
Journal cover image

Published In

BMC Public Health

DOI

EISSN

1471-2458

Publication Date

September 6, 2022

Volume

22

Issue

1

Start / End Page

1689

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Public Health
  • Malaria
  • Kenya
  • Humans
  • Family Characteristics
  • Diagnostic Tests, Routine
  • Biomedical Technology
  • 4206 Public health
  • 4203 Health services and systems