The exit interview as a proxy measure of malaria case management practice: sensitivity and specificity relative to direct observation

BMC Health Serv Res. 2014 Dec 3;14:628. doi: 10.1186/s12913-014-0628-8.


Background: This paper aims to assess the sensitivity and specificity of exit interviews as a measure of malaria case management practice as compared to direct observation.

Methods: The malaria case management of 1654 febrile patients attending 110 health facilities from across Papua New Guinea was directly observed by a trained research officer as part of a repeat cross sectional survey. Patient recall of 5 forms of clinical advice and 5 forms of clinical action were then assessed at service exit and statistical analyses on matched observation/exit interview data conducted.

Results: The sensitivity of exit interviews with respect to clinical advice ranged from 36.2% to 96.4% and specificity from 53.5% to 98.6%. With respect to clinical actions, sensitivity of the exit interviews ranged from 83.9% to 98.3% and specificity from 70.6% to 98.1%.

Conclusion: The exit interview appears to be a valid measure of objective malaria case management practices such as the completion of a diagnostic test or the provision of antimalarial medication, but may be a less valid measure of low frequency, subjective practices such as the provision of malaria prevention advice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antimalarials / therapeutic use*
  • Case Management*
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Diagnostic Tests, Routine
  • Female
  • Health Facilities
  • Humans
  • Infant
  • Interviews as Topic
  • Malaria* / drug therapy
  • Male
  • Mental Recall*
  • Observation*
  • Papua New Guinea
  • Sensitivity and Specificity
  • Young Adult


  • Antimalarials