SUAB0403 | EVALUATION OF ADHERENCE TO THE MALARIA TEST, TREAT, AND TRACK INITIATIVE: IMPLICATIONS FOR HIV PROGRAM INTEGRATION IN GHANA

Frank Ocansey¹, Justice M.k. Aheto², Dora Owusu³ | ¹Ghana Health Service, Twifo Hemang Lower Denkyira, Ghana; ²University of Ghana, Accra, Ghana; ³Ghana Health Service, Tema, Ghana

Malaria and HIV remain significant overlapping health burdens in Ghana, with co-infection leading to worsened clinical outcomes and increased complexity in patient management. Evidence shows that up to 41% of people living with HIV in Ghana may also experience malaria. The World Health Organization’s Test, Treat, and Track (T3) strategy is a cornerstone of malaria control, emphasizing systematic diagnosis, prompt treatment, and case follow-up. This study evaluated compliance with the T3 policy in two health facilities in Greater Accra and investigated possibilities for incorporating its principles into HIV care to enhance outcomes for co-infected populations. A descriptive cross-sectional study employing mixed methods was conducted. A retrospective analysis of outpatient records (January–December 2023) from two primary health facilities (Mamprobi and Ussher Hospitals) examined 3,553 suspected malaria cases. Additionally, in-depth interviews with 10 purposively selected healthcare workers explored implementation challenges. Quantitative data were analyzed with descriptive statistics; qualitative data underwent thematic analysis. High adherence to the T3 strategy was observed: 98.5% of suspected cases were tested for malaria; 99.3% of confirmed positives received ACTs; and 99.86% of treated cases were tracked via follow-up. Nonetheless, 9.5% of test-negative cases were empirically administered ACTs, signifying noncompliance with established policy. Barriers included periodic stock-outs of rapid diagnostic tests, staff shortages, limited training, and inconsistent supervision, which were also common in HIV service delivery. Healthcare workers demonstrated strong awareness of T3, but resource constraints impacted implementation fidelity. Combining malaria and HIV services was considered a good way to make the best use of resources, improve patient outcomes, and lower the risk of co-infection. This study demonstrates strong adherence to the malaria T3 policy in selected GAMA facilities, supporting Ghana’s malaria elimination goals and highlighting opportunities for integrated malaria-HIV service delivery. Addressing shared barriers such as supply chain management, continuous healthcare worker training, and enhanced supervision is essential for sustaining malaria and HIV control efforts. Although limited to two facilities and routine records, findings underscore the critical role of integrated approaches in managing malaria-HIV co-infection in high-burden communities in Ghana.