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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Quality and safety of integrated community case management of malaria using rapid diagnostic tests and pneumonia by community health workers
Pathogens and Global Health, Volume 106, No. 1, Year 2012
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Description
Objectives: To assess the quality and safety of having community health workers (CHWs) in rural Zambia use rapid diagnostic tests (RDTs) and provide integrated management of malaria and pneumonia. Design/methods: In the context of a cluster-randomized controlled trial of two models for community-based management of malaria and/or non-severe pneumonia in children under 5 years old, CHWs in the intervention arm were trained to use RDTs, follow a simple algorithm for classification and treat malaria with artemether-lumefantrine (AL) and pneumonia with amoxicillin. CHW records were reviewed to assess the ability of the CHWs to appropriately classify and treat malaria and pneumonia, and account for supplies. Patients were also followed up to assess treatment safety. Results: During the 12-month study, the CHWs evaluated 1017 children with fever and/or fast/difficult breathing and performed 975 RDTs. Malaria and/or pneumonia were appropriately classified 94-100% of the time. Treatment based on disease classification was correct in 94-100% of episodes. Supply management was excellent with over 98% of RDTs, amoxicillin, and AL properly accounted for. The use of RDTs, amoxicillin, and AL was associated with few minor adverse events. Most febrile children (90%) with negative RDT results recovered after being treated with an antipyretic alone. Conclusions: Volunteer CHWs in rural Zambia are capable of providing integrated management of malaria and pneumonia to children safely and at high quality. © W. S. Maney & Son Ltd 2012.
Authors & Co-Authors
Hamer, Davidson Howes
United States, Boston
Boston University
United States, Boston
School of Public Health
United States, Boston
Boston University Chobanian & Avedisian School of Medicine
Semrau, Katherine E.A.
United States, Boston
Boston University
United States, Boston
School of Public Health
Pilingana, Portipher
Unknown Affiliation
MacLeod, William Bruce
United States, Boston
Boston University
United States, Boston
School of Public Health
Siazeele, Kazungu
United States, Boston
Boston University
Sabin, Lora L.
United States, Boston
Boston University
United States, Boston
School of Public Health
Thea, Donald M.
United States, Boston
Boston University
United States, Boston
School of Public Health
Yeboah-Antwi, Kojo
United States, Boston
Boston University
United States, Boston
School of Public Health
Statistics
Citations: 69
Authors: 8
Affiliations: 3
Identifiers
Doi:
10.1179/1364859411Y.0000000042
ISSN:
20477732
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Randomised Control Trial
Study Approach
Quantitative
Study Locations
Zambia