Quality and safety of integrated community case management of malaria using rapid diagnostic tests and pneumonia by community health workers
| Autor: | Lora Sabin, Kojo Yeboah-Antwi, Kazungu Siazeele, Erin Twohig Brooks, Katherine Semrau, Davidson H. Hamer, Portipher Pilingana, William B. MacLeod, Donald M. Thea |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Zambia Context (language use) Microbiology law.invention Antimalarials Randomized controlled trial law parasitic diseases Pneumonia Bacterial medicine Humans Community Health Services Artemether Intensive care medicine Adverse effect Quality of Health Care Community Health Workers Fluorenes Rapid diagnostic test Delivery of Health Care Integrated business.industry Artemether Lumefantrine Drug Combination Public Health Environmental and Occupational Health Amoxicillin Infant General Medicine medicine.disease Artemisinins Anti-Bacterial Agents Malaria Drug Combinations Pneumonia Treatment Outcome Infectious Diseases Ethanolamines Child Preschool Original Article Female Parasitology Rural Health Services business Case Management Algorithms medicine.drug |
| Zdroj: | Pathogens and Global Health. 106:32-39 |
| ISSN: | 2047-7732 2047-7724 |
| DOI: | 10.1179/1364859411y.0000000042 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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