1921
Special Supplement on integrated Community Case Management
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

We compared use of community medicine distributors (CMDs) and drug use under integrated community case management and home-based management strategies in children 6–59 months of age in eastern Uganda. A cross-sectional study with 1,095 children was nested in a cluster randomized trial with integrated community case management (CMDs treating malaria and pneumonia) as the intervention and home-based management (CMDs treating only malaria) as the control. Care-seeking from CMDs was higher in intervention areas (31%) than in control areas (22%; = 0.01). Prompt and appropriate treatment of malaria was higher in intervention areas (18%) than in control areas (12%; = 0.03) and among CMD users (37%) than other health providers (9%). The mean number of drugs among CMD users compared with other health providers was 1.6 versus 2.4 in intervention areas and 1.4 versus 2.3 in control areas. Use of CMDs was low. However, integrated community case management of childhood illnesses increased use of CMDs and rational drug use.

[open-access] This is an Open Access article distributed under the terms of the American Society of Tropical Medicine and Hygiene's Re-use License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2012.11-0733
2012-11-07
2017-11-20
Loading full text...

Full text loading...

/deliver/fulltext/14761645/87/5_Suppl/36.html?itemId=/content/journals/10.4269/ajtmh.2012.11-0733&mimeType=html&fmt=ahah

References

  1. Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, Jha P, Campbell H, Walker CF, Cibulskis R, Eisele T, Liu L, Mathers C, , 2010. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet 375: 19691987.[Crossref]
  2. UNICEF, WHO, 2006. Pneumonia: The Forgotten Killer of Children. Geneva: UNICEF/WHO, 44.
  3. WHO, 2005. Malaria Control Today: Current WHO Recommendations. Geneva: WHO.
  4. Chibwana A, Mathanga D, Chinkhumba J, Campbell C, , 2009. Socio-cultural predictors of health-seeking behaviour for febrile under-five children in Mwanza-Neno district, Malawi. Malar J 8: 219.[Crossref]
  5. Warsame M, Kimbute O, Machinda Z, Ruddy P, Melkisedick M, Peto T, Ribeiro I, Kitua A, Tomson G, Gomes M, , 2007. Recognition, perceptions and treatment practices for severe malaria in rural Tanzania: implications for accessing rectal artesunate as a pre-referral. PLoS ONE 2: e149.[Crossref]
  6. Maslove D, Mnyusiwalla A, Mills E, McGowan J, Attaran A, Wilson K, , 2009. Barriers to the effective treatment and prevention of malaria in Africa: a systematic review of qualitative studies. BMC Int Health Hum Rights 9: 26.[Crossref]
  7. Kemble SK, Davis JC, Nalugwa T, Njama-Meya D, Hopkins H, Dorsey G, Staedke SG, , 2006. Prevention and treatment strategies used for the community management of childhood fever in Kampala, Uganda. Am J Trop Med Hyg 74: 9991007.
  8. Nsungwa-Sabiiti J, Tomson G, Pariyo G, Ogwal-Okeng J, Peterson S, , 2005. Community effectiveness of malaria treatment in Uganda: a long way to Abuja targets. Ann Trop Paediatr 25: 91100.[Crossref]
  9. Nsungwa-Sabiiti J, Peterson S, Pariyo G, Ogwal-Okeng J, Petzold M, Tomson G, , 2007. Home-based management of fever and malaria treatment practices in Uganda. Trans R Soc Trop Med Hyg 101: 11991207.[Crossref]
  10. Uganda Ministry of Health, 2010. Malaria Case Management: Home Based Management of Fever. Kampala, Uganda: Uganda Ministry of Health.
  11. Roll Back Malaria, 2002. Community Involvement in Rolling Back Malaria. Geneva: WHO.
  12. WHO, 2005. The Roll Back Malaria Strategy for Improving Access to Treatment through Home Management of Malaria. Geneva: WHO.
  13. Roll Back Malaria/World Health Organization, 2003. The Abuja Declaration and the Plan of Action. Geneva: World Health Organization.
  14. 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: 8.[Crossref]
  15. Sirima SB, Konate A, Tiono A, Convelbo N, Cousens S, Pagnoni F, , 2003. Early treatment of childhood fevers with pre-packaged antimalarial drugs in the home reduces severe malaria morbidity in Burkina Faso. Trop Med Int Health 8: 133139.[Crossref]
  16. Källander K, Hildenwall H, Waiswa P, Galiwango E, Peterson S, Pariyo G, , 2008. Delayed care seeking for fatal pneumonia in children aged under five years in Uganda: a case-series study. Bull World Health Organ 86: 332338.[Crossref]
  17. Källander K, Nsungwa-Sabiiti J, Peterson S, , 2004. Symptom overlap for malaria and pneumonia: policy implications for home management strategies. Acta Trop 90: 211214.[Crossref]
  18. Yeboah-Antwi K, Pilingana P, Macleod WB, Semrau K, Siazeele K, Kalesha P, Hamainza B, Seidenberg P, Mazimba A, Sabin L, Kamholz K, Thea DM, Hamer DH, , 2010. Community case management of fever due to malaria and pneumonia in children under five in Zambia: a cluster randomized controlled trial. PLoS Med 7: e1000340.[Crossref]
  19. Uganda Bureau of Statistics, Macro International Inc., 2007. Uganda Demographic and Health Survey 2006. Kampala, Uganda: Bureau of Statistics.
  20. WHO, UNICEF, 2008. Integrated Management of Childhood Illness Chart Booklet. Geneva: WHO.
  21. Rutebemberwa E, Pariyo G, Peterson S, Tomson G, Kallander K, , 2009. Utilization of public or private health care providers by febrile children after user fee removal in Uganda. Malar J 8: 45.[Crossref]
  22. Adamchak S, Bond K, MacLaren L, Magnani R, Nelson K, Seltzer J, , 2000. A Guide to Monitoring and Evaluating Adolescent Reproductive Health Programs. Washington, DC: Focus on Young Adults.
  23. Rutebemberwa E, Pariyo G, Peterson S, Tomson G, Kallander KA, , 2009. Determinants of delay in care-seeking for febrile children in eastern Uganda. Trop Med Int Health 14: 472479.[Crossref]
  24. Waiswa P, Peterson S, Tomson G, Pariyo G, , 2010. Poor newborn care practices: a population based survey in eastern Uganda. BMC Pregnancy Childbirth 10: 9.[Crossref]
  25. Gove S, , 1997. Integrated management of childhood illness by outpatient health workers: technical basis and overview. The WHO Working Group on Guidelines for Integrated Management of the Sick Child. Bull World Health Organ 75 (Suppl 1): 724.
  26. Ministry of Health, Uganda, 2010. Uganda Clinical Guidelines. Kampala, Uganda: Ministry of Health, Uganda.
  27. Department of Health Policy Planning and Management, 2010. Community Medicine Distributor Training Guide on Integrated Management of Malaria and Pneumonia. Kampala, Uganda: School of Public Health, 24.
  28. Joint Formulary Committee, 2007. British National Formulary. London: British Medical Association and Royal Pharmaceutical Society of Great Britain.
  29. Hwang J, Graves PM, Jima D, Reithinger R, Kachur SP, , 2007. Knowledge of malaria and its association with malaria-related behaviors: results from the Malaria Indicator Survey, Ethiopia. PLoS ONE 5: e11692.[Crossref]
  30. Das A, Ravindran TS, , 2010. Factors affecting treatment-seeking for febrile illness in a malaria endemic block in Boudh District, Orissa, India: policy implications for malaria control. Malar J 9: 377.[Crossref]
  31. Bakeera S, Wamala S, Galea S, State A, Peterson S, Pariyo G, , 2009. Community perceptions and factors influencing utilization of health services in Uganda. Int J Equity Health 8: 25.[Crossref]
  32. Lindblade KA, O'Neill DB, Mathanga DP, Katungu J, Wilson ML, , 2000. Treatment for clinical malaria is sought promptly during an epidemic in a highland region of Uganda. Trop Med Int Health 5: 865875.[Crossref]
  33. Tsion A, Tefera B, Ayalew T, Amare D, , 2008. Mothers' health care seeking behavior for childhood illnesses in Derra District, Northshoa Zone, Oromia Regional State, Ethiopia Ethiop. J Health Sci 18: 8794.
  34. Smith L, Bruce J, Gueye L, Helou A, Diallo R, Gueye B, Jones C, Webster J, , 2010. From fever to anti-malarial: the treatment-seeking process in rural Senegal. Malar J 9: 333.[Crossref]
  35. Mukanga D, Babirye R, Peterson S, Pariyo GW, Ojiambo G, Tibenderana JK, Nsubuga P, Kallander K, , 2011. Can lay community health workers be trained to use diagnostics to distinguish and treat malaria and pneumonia in children? Lessons from rural Uganda. Trop Med Int Health 16: 12341242.[Crossref]
  36. 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: 394399.
  37. Hoa N, Trung N, Larsson M, Eriksson B, Phuc H, Chuc N, Lundborg C, , 2010. Decreased Streptococcus pneumoniae susceptibility to oral antibiotics among children in rural Vietnam: a community study. BMC Infect Dis 10: 85.[Crossref]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2012.11-0733
Loading
/content/journals/10.4269/ajtmh.2012.11-0733
Loading

Data & Media loading...

  • Received : 25 Nov 2011
  • Accepted : 22 Jan 2012

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error