Enhancing Physicians' Adherence to the 2023 Sudan Malaria Case Management Protocol Using AI as an Intervention Tool

Area of Science:

• Medical Informatics
• Infectious Disease Management
• Public Health

Background:

• Malaria poses a significant health burden in Sudan, with physician non-adherence to treatment protocols impacting patient outcomes.
• The 2023 Sudan Malaria Case Management Protocol introduced updated guidelines, yet clinical practice gaps persist.
• Artificial intelligence (AI) offers potential for developing clinical decision-support systems (CDSS) to standardize malaria care.

Purpose of the Study:

• To evaluate the impact of an AI-based CDSS on physician adherence to the 2023 Sudan Malaria Case Management Protocol.
• To assess improvements in malaria diagnosis and treatment practices following AI implementation.

Main Methods:

• A two-cycle clinical audit involving 50 physicians at Al-Managil Teaching Hospital.
• Pre-intervention assessment via questionnaires, followed by AI-CDSS implementation and training.
• Comparison of compliance rates before and after AI intervention using statistical analysis.

Main Results:

• Protocol recognition increased from 38% to 100%, and awareness of artesunate as first-line treatment rose from 53% to 98%.
• Attitudes toward severe malaria management improved significantly (15% to 91%), with 100% timely treatment initiation.
• Mean compliance escalated from 50.7% to 96.8%, although microscopy reporting and G6PD testing showed residual deficiencies.

Conclusions:

• AI-driven CDSS combined with training substantially enhanced physician compliance with malaria protocols.
• Limitations include potential Hawthorne effect and lack of clinical outcome data.
• Scaling this approach requires addressing infrastructural and digital literacy challenges for broader impact on malaria burden in Sudan.