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Review: Provider Practice and User Behavior Interventions to Improve Prompt and Effective Treatment of Malaria: Do We Know What Works?

Effective case management of uncomplicated malaria is a cornerstone of successful malaria control. With current calls for the global elimination of malaria, all strategies to control malaria need to reach the highest achievable level of effective implementation. A systematic literature review of all interventions to improve provider- and/or user-side behavior in the prompt and appropriate treatment of uncomplicated malaria (with appropriate evaluation design and Roll Back Malaria outcome indicators) found 23 studies for review. Only 16 studies targeted providers, nine in the public sector and seven in the private sector. Just four interventions were conducted at national scale. These data suggest that very little is known about what interventions work in improving prompt and effective treatment of malaria. In the context of scaling up effective malaria control and malaria elimination plans and in increasing access to artemisinin combination therapies (ACTs), increased research in this area is crucial.

Received September 16, 2008. Accepted for publication November 7, 2008.

Acknowledgments: The authors thank Pfizer’s Mobilize Against Malaria initiative for providing the funding to support this research.

Disclaimer: The findings, views, and opinions expressed in this article are those of the authors and not of Pfizer Inc.

^* Address correspondence to Lucy A. Smith, Disease Control and Vector Biology Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom. E-mail: Lucy.Smith{at}lshtm.ac.uk

Authors’ addresses: Lucy A. Smith, Disease Control and Vector Biology Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom, Tel: +44 (0)207 927 2440, Fax: +44 (0) 207 580 9075, E-mail: Lucy.Smith{at}lshtm.ac.uk. Caroline Jones, Disease Control and Vector Biology Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom, Tel: +44 (0)207 927 2649, Fax: +44 (0) 207 580 9075. Sylvia Meek, Malaria Consortium, Development House, 56-64 Leonard Street, London EC2A 4LT, United Kingdom, Tel: +44 (0)20 7549 0210, Fax: +44 (0)20 7549 0211. Jayne Webster, Disease Control and Vector Biology Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom, Tel: +44 (0)207 927 2648, Fax: +44 (0) 207 580 9075.