Practices and challenges related to management of chikungunya and non-malarial acute febrile illnesses in malaria-endemic areas of Afar region, Northeast Ethiopia

Chikungunya (CHIK) and non-malarial febrile illnesses are emerging as significant public health concerns in tropical and subtropical regions, including Ethiopia. Case management, including diagnostic capacity and technical proficiency, is essential for accurate identification and improved clinical outcomes. This study assessed healthcare workers’ (HCWs) practices and challenges related to the management of CHIK and non-malarial acute febrile illnesses in malaria-endemic areas of the Afar Region, Northeast Ethiopia. A mixed-methods approach was utilized across six healthcare facilities in the Afar Region. Quantitative data were gathered through a self-administered questionnaire from 82 HCWs, and qualitative data through in-depth interviews (IDIs) with 10 HCWs. Retrospective data of febrile cases recorded for one year were extracted from four healthcare facilities. Data analysis included descriptive statistics and an independent samples t-test for quantitative data and thematic analysis for qualitative findings. Of quantitative study participants, 93.6% of HCWs had prior information about CHIK, with an overall mean knowledge score of 10.7, indicating a fair understanding (56.3%), with a significantly higher mean knowledge score observed among individuals holding a master’s or doctoral degree. However, only 23.4% participants demonstrated good knowledge scores, revealing significant gaps in their understanding of CHIK transmission and prevention. While malaria was the primary diagnosis (95.1%), it is noteworthy that 59.2% of the febrile cases were identified as non-malarial. Several challenges were identified, including lack of diagnostic tools, inadequate training for HCWs and community misconceptions about non-malarial febrile illnesses. Participants in IDI also highlighted the issue of misdiagnosing febrile illnesses due to overlapping symptoms and reliance on clinical judgments. This study revealed significant gaps in practices and systemic challenges hinder effective management of non-malarial febrile illnesses, including CHIK, in malaria-endemic areas of the Afar Region. Strengthening diagnostic capacity, HCW training, diagnostic capacity building, and public awareness is essential for improving outcomes in malaria-endemic areas.