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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Deploying artemether-lumefantrine with rapid testing in Ethiopian communities: Impact on malaria morbidity, mortality and healthcare resources
Tropical Medicine and International Health, Volume 15, No. 2, Year 2010
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Description
Objective To assess the impact and feasibility of artemether-lumefantrine deployment at community level, combined with phased introduction of rapid diagnostic tests (RDTs), on malaria transmission, morbidity, and mortality and health service use in a remote area of Ethiopia. Methods Two-year pilot study in two districts: Artemether-lumefantrine was prescribed after parasitological confirmation of malaria in health facilities in both districts. In the intervention district, artemether-lumefantrine was also made available through 33 community health workers (CHWs); of these, 50% were equipped with RDTs in the second year. Results At health facilities; 54 774 patients in the intervention and 100 535 patients in the control district were treated for malaria. In the intervention district, 75 654 patients were treated for malaria by community health workers. Use of RDTs in Year 2 excluded non-Plasmodium falciparumin 89.7% of suspected cases. During the peak of malaria transmission in 2005, the crude parasite prevalence was 7.4% (95% CI: 6.1-8.9%) in the intervention district and 20.8% (95% CI: 18.7-23.0%) in the control district. Multivariate modelling indicated no significant difference in risk of all-cause mortality between the intervention and the control districts [adjusted incidence rate ratio (aIRR) 1.03, 95%CI 0.87-1.21, P = 0.751], but risk of malaria-specific mortality was lower in the intervention district (aIRR 0.60, 95%CI 0.40-0.90, P = 0.013). Conclusions Artemether-lumefantrine deployment through a community-based service in a remote rural population reduced malaria transmission, lowered the malaria case burden for health facilities and reduced malaria morbidity and mortality during a 2-year period which included a major malaria epidemic. © 2009 Blackwell Publishing Ltd.
Authors & Co-Authors
Lemma, Hailemariam
Ethiopia, Makale
Tigray Health Bureau
Byass, P.
Sweden, Umea
Umeå Universitet
Wuneh, Alem Desta
Ethiopia, Makale
Tigray Health Bureau
Bosman, Andrea
Switzerland, Geneva
Organisation Mondiale de la Santé
Costanzo, G.
Italy, Rome
Italian Ministry of Labour Health and Social Policies - Health Sector
Toma, Luigi
Italy, Rome
Irccs Istituto Dermatologico San Gallicano
Fottrell, Edward F.
Sweden, Umea
Umeå Universitet
Marrast, Anne Claire
Switzerland, Basel
Novartis International ag
Ambachew, Yohannes
Switzerland, Geneva
Organisation Mondiale de la Santé
Getachew, Asefaw
Ethiopia, Makale
Tigray Health Bureau
Mulure, Nathan
Kenya, Nairobi
Novartis Pharma ag
Morrone, Aldo
Unknown Affiliation
Bianchi, Angela
Italy, Origgio
Novartis Farma S.p.a
Barnabas, Gebre Ab
Ethiopia, Makale
Tigray Health Bureau
Statistics
Citations: 64
Authors: 14
Affiliations: 9
Identifiers
Doi:
10.1111/j.1365-3156.2009.02447.x
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Study Locations
Ethiopia