Design, implementation and evaluation of a training programme for school teachers in the use of malaria rapid diagnostic tests as part of a basic first aid kit in southern Malawi

BMC Public Health

Research Article

Charles Mazinga¹  Katherine E. Halliday²  Simon J. Brooker²  Reuben Mwenda³  Don P. Mathanga⁴  John Sande⁵  Doreen Ali⁵  David Melody⁶  Austin Mtali⁶  Allison Verney⁶  Tiyese Chimuna⁶  Stefan Witek-McManus⁷  Natalie Roschnik⁸  Emmanuel Phondiwa⁹  Saidi Ndau^1,10 

[1] Department of School Health, Nutrition, HIV & AIDS, Ministry of Education, Science & Technology, Lilongwe, Malawi;Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK;Health Technical Support Services-Diagnostics, Ministry of Health, Lilongwe, Malawi;Malaria Alert Centre, College of Medicine, University of Malawi, Blantyre, Malawi;National Malaria Control Programme, Ministry of Health, Lilongwe, Malawi;Save the Children International, Zomba, Malawi;Save the Children International, Zomba, Malawi;Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK;Save the Children USA, Washington, DC, USA;Zomba District Education Office, Ministry of Education, Science & Technology, Zomba, Malawi;Zomba District Health Office, Ministry of Health, Zomba, Malawi;

关键词: Malaria;    Community Health Worker;    Uncomplicated Malaria;    Artemisinin Combination Therapy;    Final Training;   

DOI  :  10.1186/s12889-015-2228-x

 received in 2015-02-02, accepted in 2015-09-04,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundWith increasing levels of enrolment, primary schools present a pragmatic opportunity to improve the access of school children to timely diagnosis and treatment of malaria, increasingly recognised as a major health problem within this age group. The expanded use of malaria rapid diagnostic tests (RDTs) and artemisinin combination therapy (ACT) by community health workers (CHWs) has raised the prospect of whether teachers can provide similar services for school children. We describe and evaluate the training of primary school teachers to use a first aid kit containing malaria RDTs and ACT for the diagnosis and treament of uncomplicated malaria in school children in southern Malawi.MethodsWe outline the development of the intervention as: (1) conception and design, (2) pilot training, (3) final training, and (4) 7-month follow up. The training materials were piloted at a four-day workshop in July 2013 following their design at national stakeholders meetings. The evaluation of the pilot training and materials were assessed in relation to increased knowledge and skill sets using checklist evaluations and questionnaires, the results of which informed the design of a final seven-day training programme held in December 2013. A follow up of trained teachers was carried out in July 2014 following 7 months of routine implementation. A total of 15 teachers were evaluated at four stages: pilot training, two weeks following pilot, final training and seven months following final training.ResultsA total of 15 and 92 teachers were trained at the pilot and final training respectively. An average of 93 % of the total steps required to use RDTs were completed correctly at the final training, declining to 87 % after 7 months. All teachers were observed correctly undertaking safe blood collection and handling, accurate RDT interpretation, and correct dispensing of ACT. The most commonly observed errors were a failure to wait 20 minutes before reading the test result, and adding an incorrect volume of buffer to the test cassette.ConclusionFollowing training, teachers are able to competently use RDTs and ACTs test and treat children at school for uncomplicated malaria safely and accurately. Teachers demonstrate a comparable level of RDT use relative to non-health professional users of RDTs, and sustain this competency over a period of seven months during routine implementation.

【 授权许可】

CC BY   
© Witek-McManus et al. 2015