Abstract
BackgroundAccess to prompt and effective treatment is a cornerstone of the current malaria control strategy. Delays in starting appropriate treatment is a major contributor to malaria mortality. WHO recommends home management of malaria using artemisininbased combination therapy (ACT) and Rapid Diagnostic tests (RDTs) as one of the strategies for improving access to prompt and efective malaria case management.MethodsA prospective evaluation of the effectiveness of using community health workers (CHWs) as delivery points for ACT and RDTs in the home management of malaria in two districts in Zambia.ResultsCHWs were able to manage malaria fevers by correctly interpreting RDT results and appropriately prescribing antimalarials. All severe malaria cases and febrile non-malaria fevers were referred to a health facility for further management. There were variations in malaria prevalence between the two districts and among the villages in each district. 100% and 99.4% of the patients with a negative RDT result were not prescribed an antimalarial in the two districts respectively. No cases progressed to severe malaria and no deaths were recorded during the study period. Community perceptions were positive.ConclusionCHWs are effective delivery points for prompt and effective malaria case management at community level. Adherence to test results is the best ever reported in Zambia. Further areas of implementation research are discussed.
Highlights
Access to prompt and effective treatment is a cornerstone of the current malaria control strategy
Many children with suspected malaria in sub-Saharan Africa, where medical services are not accessible, start treatment too late or do not receive it at all and die at home without contact with formal medical services [2,3]. It is for this reason that the World Health Organization has recommended home management of malaria (HMM) as one of the strategies for improving access to prompt and effective malaria
There were more female patients than were males in both districts. This is consistent with the ZDHS 2007 estimates which show that the Zambian population has more females than males (52% vs 48%) respectively [17]
Summary
Access to prompt and effective treatment is a cornerstone of the current malaria control strategy. WHO recommends home management of malaria using artemisininbased combination therapy (ACT) and Rapid Diagnostic tests (RDTs) as one of the strategies for improving access to prompt and efective malaria case management. Many children with suspected malaria in sub-Saharan Africa, where medical services are not accessible, start treatment too late or do not receive it at all and die at home without contact with formal medical services [2,3]. It is for this reason that the World Health Organization has recommended home management of malaria (HMM) as one of the strategies for improving access to prompt and effective malaria. Scaling-up of the HMM strategy has been shown to reduce workload in health facilities [10] and might contribute to minimize the consequences of workforce shortage at peripheral health facilities level, and possibly improve their performance
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
