{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:51:21Z","timestamp":1791521481920,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Challenges"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Management of severe malaria among children remains a challenge in sub\u2010Saharan Africa, including Malawi. Therefore, this study examined the adherence to the national malaria case management guidelines among Malawian healthcare workers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a mixed\u2010methods study that used purposive sampling to recruit nurses and clinicians in paediatric and nursery wards. Quantitative data were collected from 33 participants through a clinical observational checklist. Qualitative data were collected from 12 participants through in\u2010depth interviews. Quantitative data were analysed using SPSS version 22.0, and qualitative data were analysed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results indicated that 32\/33 of the participants effectively treated under\u2010five children with severe malaria, whereas 23\/33 of the participants made incorrect diagnoses. Additionally, the general paediatric ward nurses did not appropriately monitor the patients. Most healthcare workers failed to provide adequate health education and follow\u2010up appointments for the discharged children and their guardians due to a shortage of staff, lack of equipment and lack of commitment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study suggests that there is poor adherence to the national malaria guidelines on the management of children with severe malaria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/puh2.70371","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:45:41Z","timestamp":1791521141000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adherence to the Revised National Malaria Case Management Guidelines Among Healthcare Workers at Mzimba District Hospital in Northern Malawi"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8877-7428","authenticated-orcid":false,"given":"Rita Luhanga","family":"Soko","sequence":"first","affiliation":[{"name":"Mzuzu Urban Community Hospital Mzimba North District Health Office Mzuzu Malawi"},{"name":"Kamuzu University of Health Sciences  Lilongwe Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6224-9913","authenticated-orcid":false,"given":"Chisomo","family":"Mulenga","sequence":"additional","affiliation":[{"name":"Kamuzu University of Health Sciences  Lilongwe Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0011-269X","authenticated-orcid":false,"given":"Thokozani","family":"Mzumara","sequence":"additional","affiliation":[{"name":"Mzuzu Urban Community Hospital Mzimba North District Health Office Mzuzu Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandayachepa Clifford","family":"Nyando","sequence":"additional","affiliation":[{"name":"Kamuzu University of Health Sciences  Lilongwe Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"World Health Organization WHO Guidelines for Malaria(World Health Organization 2024)."},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2023.102379","article-title":"One Hundred Malaria Attacks Since Birth. A Longitudinal Study of African Children and Young Adults Exposed to High Malaria Transmission","volume":"67","author":"Trape J. F.","year":"2024","journal-title":"EClinicalMedicine"},{"key":"e_1_2_11_4_1","volume-title":"20 Years of Global Progress and Challenges","author":"World Health Organization","year":"2020"},{"issue":"1","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1186\/s12913-019-4544-9","article-title":"Challenges Affecting Prompt Access to Adequate Uncomplicated Malaria Case Management in Children in Rural Primary Health Facilities in Chikhwawa Malawi","volume":"19","author":"Klootwijk L.","year":"2019","journal-title":"BMC Health Services Research"},{"key":"e_1_2_11_6_1","volume-title":"Guidelines for the Treatment of Malaria in Malawi","author":"Ministry of Health (MoH)","year":"2020"},{"issue":"1","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1186\/s12936-020-03341-2","article-title":"Predictors of Health Workers\u2032 Knowledge About Artesunate\u2010Based Severe Malaria Treatment Recommendations in Government and Faith\u2010Based Hospitals in Kenya","volume":"19","author":"Machini B.","year":"2020","journal-title":"Malaria Journal"},{"issue":"1","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1186\/s12936-016-1423-2","article-title":"Adherence to National Guidelines for the Diagnosis and Management of Severe Malaria: A Nationwide, Cross\u2010Sectional Survey in Malawi, 2012","volume":"15","author":"Shah M. 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A.","year":"2019","journal-title":"Malaria Journal"},{"issue":"6","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"498","DOI":"10.12980\/APJTB.4.2014C153","article-title":"A Retrospective Evaluation of the Quality of Malaria Case Management at Twelve Health Facilities in Four Districts in Zambia","volume":"4","author":"Chanda\u2010Kapata P.","year":"2014","journal-title":"Asian Pacific Journal of Tropical Biomedicine"},{"issue":"9","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0185435","article-title":"Complicated Malaria in Children and Adults From Three Settings of the Colombian Pacific Coast: A Prospective Study","volume":"12","author":"Ar\u00e9valo\u2010Herrera M.","year":"2017","journal-title":"PLoS ONE"},{"issue":"3","key":"e_1_2_11_13_1","first-page":"e41","article-title":"High Postdischarge Morbidity in Ugandan Children With Severe Malarial Anemia or Cerebral Malaria","volume":"6","author":"Opoka R. O.","year":"2017","journal-title":"Journal of the Pediatric Infectious Diseases Society"},{"key":"e_1_2_11_14_1","unstructured":"UNICEF 2019\/20 Child Immunization Budget Brief(UNICEF) 2018."},{"issue":"1","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12936-016-1650-6","article-title":"Incidence and Admission Rates for Severe Malaria and Their Impact on Mortality in Africa","volume":"16","author":"Camponovo F.","year":"2017","journal-title":"Malaria Journal"},{"key":"e_1_2_11_16_1","unstructured":"UNICEFChildhood Diseases(UNICEF 2021)."},{"issue":"1","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-058511","article-title":"Cross\u2010Sectional Study to Predict Subnational Levels of Health Workers\u2032 Knowledge About Severe Malaria Treatment in Kenya","volume":"12","author":"Machini B.","year":"2022","journal-title":"BMJ Open"},{"issue":"1","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1186\/1475-2875-10-279","article-title":"Knowledge and Malaria Treatment Practices Using Artemisinin Combination Therapy (ACT) in Malawi: Survey of Health Professionals","volume":"10","author":"Kalilani\u2010Phiri L. 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Malar J21 284(2022).https:\/\/doi.org\/10.1186\/s12936-022-04301-8.","DOI":"10.1186\/s12936-022-04301-8"},{"issue":"2","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004189","article-title":"Health Worker Compliance With Severe Malaria Treatment Guidelines in the Context of Implementing Pre\u2010Referral Rectal Artesunate in the Democratic Republic of the Congo, Nigeria, and Uganda: An Operational Study","volume":"20","author":"Signorell A.","year":"2023","journal-title":"PLoS Medicine"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpopen.2025.100139"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.18\u20100366"},{"issue":"1","key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12936-022-04048-2","article-title":"Adherence to Malaria Management Guidelines by Health Care Workers in the Busoga Sub\u2010Region, Eastern Uganda","volume":"21","author":"Mpimbaza A.","year":"2022","journal-title":"Malaria Journal"},{"issue":"1","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s12936-019-2670-9","article-title":"Prescribing Patterns and Compliance With World Health Organization Recommendations for the Management of Severe Malaria: A Modified Cohort Event Monitoring Study in Public Health Facilities in Ghana and Uganda","volume":"18","author":"Ampadu H. 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