Volume 80, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


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.


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  1. Snow RW, Craig M, Deichmann U, Marsh K, 1999. Estimating mortality, morbidity and disability due to malaria among Africa’s non-pregnant population. Bull World Health Organ 77 : 624–640. [Google Scholar]
  2. Bill and Melinda Gates Foundation, 2007. Opening and Foundation’s Vision for Malaria. Malaria Forum–Day 2. Seattle.
  3. RBM, 2008. The Global Malaria Action Plan: For a Malaria-free World. Geneva: Roll Back Malaria Partnership.
  4. RBM, 2005. Global Strategic Plan: Roll Back Malaria 2005–2015. Geneva: Roll Back Malaria Partnership.
  5. WHO, 2008. World Malaria Report 2008. Geneva: World Health Organization.
  6. WHO, 1993. Global Srategy for Malaria Control. Geneva: World Health Organization.
  7. Williams HA, Jones CO, 2004. A critical review of behavioural issues related to malaria control in sub-Saharan Africa: what contributions have social scientists made? Soc Sci Med 59 : 501–523. [Google Scholar]
  8. Brugha R, Zwi A, 1998. Improving the quality of private sector delivery of public health services: challenges and strategies. Health Policy Plan 13 : 107–120. [Google Scholar]
  9. Goodman C, Brieger W, Unwin A, Mills A, Meek S, Greer G, 2007. Medicine sellers and malaria treatment in sub-Saharan Africa: what do they do and how can their practice be improved? Am J Trop Med Hyg 77 : 203–218. [Google Scholar]
  10. Gyapong M, Garshong B, 2007. Lessons Learned in Home Management of Malaria: Implementation Research in Four African Countries. Geneva: WHO.
  11. Ross-Degnan D, Laing R, Santoso B, Ofori-Adjei D, Lamoureux C, Hogerzeil H, 1997. Improving pharmaceutical use in primary care in developing countries: a critical review of experience and lack of experience. International Conference on Improving Use of Medicines. Chiang Mai, Thailand.
  12. Habicht JP, Victora CG, Vaughan JP, 1999. Evaluation designs for adequacy, plausibility and probability of public health programme performance and impact. Int J Epidemiol 28 : 10–18. [Google Scholar]
  13. RBM, 2000. Framework for Monitoring Progress and Evaluationg Outcomes and Impact. Geneva: Roll Back Malaria Partnership.
  14. Armstrong Schellenberg J, Bryce J, de Savigny D, Lambrechts T, Mbuya C, Mgalula L, Wilczynska K, 2004. The effect of Integrated Management of Childhood Illness on observed quality of care of under-fives in rural Tanzania. Health Policy Plan 19 : 1–10. [Google Scholar]
  15. Gouws E, Bryce J, Habicht JP, Amaral J, Pariyo G, Schellenberg JA, Fontaine O, 2004. Improving antimicrobial use among health workers in first-level facilities: results from the multi-country evaluation of the Integrated Management of Childhood Illness strategy. Bull World Health Organ 82 : 509–515. [Google Scholar]
  16. Ajayi IO, Browne EN, Garshong B, Bateganya F, Yusuf B, Agyei-Baffour P, Doamekpor L, Balyeku A, Munguti K, Cousens S, Pagnoni F, 2008. Feasibility and acceptability of artemisinin-based combination therapy for the home management of malaria in four African sites. Malar J 7 : 6. [Google Scholar]
  17. Obua C, Ogwal-Okeng JW, Waako P, Aupont O, Ross-Degnan D, 2004. Impact of an educational intervention to improve prescribing by private physicians in Uganda. East Afr Med J (Suppl): S17–S24. [Google Scholar]
  18. Ofori-Adjei D, Arhinful DK, 1996. Effect of training on the clinical management of malaria by medical assistants in Ghana. Soc Sci Med 42 : 1169–1176. [Google Scholar]
  19. Tavrow P, Rennie W, 2004. Neighbour-to-Neighbour Education to Improve Malaria Treatment in Households in Bungoma District, Kenya. Operations Research Results Bethesda: Quality Assurance Project.
  20. Winch PJ, Bagayoko A, Diawara A, Kane M, Thiero F, Gilroy K, Daou Z, Berthe Z, Swedberg E, 2003. Increases in correct administration of chloroquine in the home and referral of sick children to health facilities through a community-based intervention in Bougouni District, Mali. Trans R Soc Trop Med Hyg 97 : 481–490. [Google Scholar]
  21. Yeboah-Antwi K, Gyapong JO, Asare IK, Barnish G, Evans DB, Adjei S, 2001. Impact of prepackaging antimalarial drugs on cost to patients and compliance with treatment. Bull World Health Organ 79 : 394–399. [Google Scholar]
  22. Ansah EK, Gyapong JO, Agyepong IA, Evans DB, 2001. Improving adherence to malaria treatment for children: the use of pre-packed chloroquine tablets vs. chloroquine syrup. Trop Med Int Health 6 : 496–504. [Google Scholar]
  23. Greer G, Akinpelumi A, Madueke L, Plowman B, Fapohunda B, Tawfik Y, Holmes R, Owor J, Gilpin U, Clarence C, Lennox B, 2004. Improving Management of Childhood Malaria in Nigeria and Uganda by Improving Practices of Patent Medicine Vendors. Arlington, Va: BASICS II for the US Agency for International Development.
  24. Kaona FA, Tuba M, 2003. Improving ability to identify malaria and correctly use chloroquine in children at household level in Nakonde district, Northern Province of Zambia. Malar J 2 : 43. [Google Scholar]
  25. Kofoed PE, Lopez F, Aaby P, Hedegaard K, Rombo L, 2003. Can mothers be trusted to give malaria treatment to their children at home? Acta Trop 86 : 67–70. [Google Scholar]
  26. Nkuo Akenji TK, Ntonifor NN, Ching JK, Kimbi HK, Ndamukong KN, Anong DN, Boyo MG, Titanji VP, 2005. Evaluating a malaria intervention strategy using knowledge, practices and coverage surveys in rural Bolifamba, southwest Cameroon. Trans R Soc Trop Med Hyg 99 : 325–332. [Google Scholar]
  27. Nsimba SE, 2007. Assessing the impact of educational intervention for improving management of malaria and other childhood illnesses in Kibaha District-Tanzania. East Afr J Public Health 4 : 5–11. [Google Scholar]
  28. Nsungwa-Sabiiti J, Peterson S, Pariyo G, Ogwal-Okeng J, Petzold MG, Tomson G, 2007. Home-based management of fever and malaria treatment practices in Uganda. Trans R Soc Trop Med Hyg 101 : 1199–1207. [Google Scholar]
  29. Okonkwo PO, Akpala CO, Okafor HU, Mbah AU, Nwaiwu O, 2001. Compliance to correct dose of chloroquine in uncomplicated malaria correlates with improvement in the condition of rural Nigerian children. Trans R Soc Trop Med Hyg 95 : 320–324. [Google Scholar]
  30. Pagnoni F, Convelbo N, Tiendrebeogo J, Cousens S, Esposito F, 1997. A community-based programme to provide prompt and adequate treatment of presumptive malaria in children. Trans R Soc Trop Med Hyg 91 : 512–517. [Google Scholar]
  31. Tavrow P, Shabahang J, Makama S, 2003. Vendor-to-vendor education to improve malaria treatment by private drug outlets in Bungoma district, Kenya. Malar J 2 : 10. [Google Scholar]
  32. Tawfik Y, Nsungwa-Sabitii J, Greer G, Owor J, Kesande R, Prysor-Jones S, 2006. Negotiating improved case management of childhood illness with formal and informal private practitioners in Uganda. Trop Med Int Health 11 : 967–973. [Google Scholar]
  33. Marsh VM, Mutemi WM, Willetts A, Bayah K, Were S, Ross A, Marsh K, 2004. Improving malaria home treatment by training drug retailers in rural Kenya. Trop Med Int Health 9 : 451–460. [Google Scholar]
  34. Afenyadu GY, Agyepong IA, Barnish G, Adjei S, 2005. Improving access to early treatment of malaria: a trial with primary school teachers as care providers. Trop Med Int Health 10 : 1065–1072. [Google Scholar]
  35. Bradley J, Igras S, 2005. Improving the quality of child health services: participatory action by providers. Int J Qual Health Care 17 : 391–399. [Google Scholar]
  36. Tavrow P, Shabahang J, Makama S, 2002. Vendor-to-Vendor Education to Improve Malaria Treatment by Drug Outlets in Kenya. Operations Research Results. Bethesda: Quality Assurance Project.
  37. Menon A, Joof D, Rowan KM, Greenwood BM, 1988. Maternal administration of chloroquine: an unexplored aspect of malaria control. J Trop Med Hyg 91 : 49–54. [Google Scholar]
  38. Griffiths M, 1990. Using anthropological techniques in program design: successful nutrition education in Indonesia, in Anthropology and Primary Health Care, Coreil J, Mull J, eds. Boulder, CO: Westview Press.
  39. Yoder PS, 1997. Negotiating relevance: belief, knowledge, and practice in international health projects. Med Anthropol Q 11 : 131–146. [Google Scholar]
  40. Marsh VM, Mutemi WM, Muturi J, Haaland A, Watkins WM, Otieno G, Marsh K, 1999. Changing home treatment of childhood fevers by training shop keepers in rural Kenya. Trop Med Int Health 4 : 383–389. [Google Scholar]
  41. Abuya TO, Mutemi W, Karisa B, Ochola SA, Fegan G, Marsh V, 2007. Use of over-the-counter malaria medicines in children and adults in three districts in Kenya: implications for private medicine retailer interventions. Malar J 6 : 57. [Google Scholar]
  42. Conteh L, Stevens W, Wiseman V, 2007. The role of communication between clients and health care providers: implications for adherence to malaria treatment in rural Gambia. Trop Med Int Health 12 : 382–391. [Google Scholar]
  43. Ogwal-Okeng JW, Obua C, Waako P, Aupont O, Ross-Degnan D, 2004. A comparison of prescribing practices between public and private sector physicians in Uganda. East Afr Med J (Suppl): S12–S16. [Google Scholar]
  44. Djimde A, Plowe CV, Diop S, Dicko A, Wellems TE, Doumbo O, 1998. Use of antimalarial drugs in Mali: policy versus reality. Am J Trop Med Hyg 59 : 376–379. [Google Scholar]
  45. Fogg C, Bajunirwe F, Piola P, Biraro S, Checchi F, Kiguli J, Namiiro P, Musabe J, Kyomugisha A, Guthmann JP, 2004. Adherence to a six-dose regimen of artemetherlumefantrine for treatment of uncomplicated Plasmodium falciparum malaria in Uganda. Am J Trop Med Hyg 71 : 525–530. [Google Scholar]
  46. Kachur SP, Khatib RA, Kaizer E, Fox SS, Abdulla SM, Bloland PB, 2004. Adherence to antimalarial combination therapy with sulfadoxine-pyrimethamine and artesunate in rural Tanzania. Am J Trop Med Hyg 71 : 715–722. [Google Scholar]
  47. Homedes N, Ugalde A, 2001. Improving the use of pharmaceuticals through patient and community level interventions. Soc Sci Med 52 : 99–134. [Google Scholar]
  48. Yeung S, White NJ, 2005. How do patients use antimalarial drugs? A review of the evidence. Trop Med Int Health 10 : 121–138. [Google Scholar]
  49. Eriksen J, Nsimba SE, Minzi OM, Sanga AJ, Petzold M, Gustafsson LL, Warsame MY, Tomson G, 2005. Adoption of the new anti-malarial drug policy in Tanzania–a cross-sectional study in the community. Trop Med Int Health 10 : 1038–1046. [Google Scholar]
  50. Biritwum RB, 2001. Impact of health care financing reforms on the management of malaria in Ghana. East Afr Med J 78 : 636–640. [Google Scholar]
  51. Chandler CI, Jones C, Boniface G, Juma K, Reyburn H, Whitty CJ, 2008. Guidelines and mindlines: why do clinical staff over-diagnose malaria in Tanzania? A qualitative study. Malar J 7 : 53. [Google Scholar]
  52. Osterholt DM, Rowe AK, Hamel MJ, Flanders WD, Mkandala C, Marum LH, Kaimila N, 2006. Predictors of treatment error for children with uncomplicated malaria seen as outpatients in Blantyre district, Malawi. Trop Med Int Health 11 : 1147–1156. [Google Scholar]
  53. Rowe AK, Hamel MJ, Flanders WD, Doutizanga R, Ndoyo J, Deming MS, 2000. Predictors of correct treatment of children with fever seen at outpatient health facilities in the Central African Republic. Am J Epidemiol 151 : 1029–1035. [Google Scholar]
  54. Rowe AK, Onikpo F, Lama M, Deming MS, 2003. Risk and protective factors for two types of error in the treatment of children with fever at outpatient health facilities in Benin. Int J Epidemiol 32 : 296–303. [Google Scholar]
  55. Zurovac D, Rowe AK, Ochola SA, Noor AM, Midia B, English M, Snow RW, 2004. Predictors of the quality of health worker treatment practices for uncomplicated malaria at government health facilities in Kenya. Int J Epidemiol 33 : 1080–1091. [Google Scholar]
  56. Rowe AK, de Savigny D, Lanata CF, Victora CG, 2005. How can we achieve and maintain high-quality performance of health workers in low-resource settings? Lancet 366 : 1026–1035. [Google Scholar]
  57. Zurovac D, Ndhlovu M, Sipilanyambe N, Chanda P, Hamer DH, Simon JL, Snow RW, 2007. Paediatric malaria case-management with artemetherlumefantrine in Zambia: a repeat cross-sectional study. Malar J 6 : 31. [Google Scholar]
  58. McCombie SC, 1996. Treatment seeking for malaria: a review of recent research. Soc Sci Med 43 : 933–945. [Google Scholar]
  59. Haines A, Sanders D, Lehmann U, Rowe AK, Lawn JE, Jan S, Walker DG, Bhutta Z, 2007. Achieving child survival goals: potential contribution of community health workers. Lancet 369 : 2121–2131. [Google Scholar]
  60. Orton L, Barnish G, 2005. Unit-dose packaged drugs for treating malaria. Cochrane Database Syst Rev CD004614. [Google Scholar]

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  • Received : 16 Sep 2008
  • Accepted : 07 Nov 2008

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