Community case management in malaria: review and perspectives after four years of operational experience in Saraya district, south-east Senegal

Malaria Journal

Research

David Schellenberg¹  Demetri Blanas²  Paul Milligan³  Omar Gaye⁴  Jean LA Ndiaye⁴  Badara Cisse⁴  Mouhamed Ndiaye⁴  Mansour Ndiath⁴  Sylvain L Faye⁵  Mamoudou Bocoum⁶  Doudou Sene⁷  Pape M Thior⁷  Youssoupha Ndiaye⁷  Jonas Bassene⁷  Isaac A Manga⁷ 

[1] Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK;Department of Family Medicine, Icahn School of Medicine at Mount Sinai, New York, USA;Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK;Department of Medical Parasitology, University Cheikh Anta Diop, Dakar, Senegal;Department of Sociology, University Cheikh Anta Diop, Dakar, Senegal;Health Service Division, Oromin Joint Venture Group, Sabodala, Senegal;Ministry of Health and Social Action, Dakar, Senegal;

关键词: Malaria;    Community case management;    Community health;   

DOI  :  10.1186/1475-2875-12-240

 received in 2013-04-01, accepted in 2013-07-08,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundDespite recent advances in malaria diagnosis and treatment, many isolated communities in rural settings continue to lack access to these life-saving tools. Community-case management of malaria (CCMm), consisting of lay health workers (LHWs) using malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) in their villages, can address this disparity.MethodsThis study examined routine reporting data from a CCMm programme between 2008 and 2011 in Saraya, a rural district in Senegal, and assessed its impact on timely access to rapid diagnostic tests and ACT.ResultsThere was a seven-fold increase in the number of LHWs providing care and in the number of patients seen. LHW engagement in the CCM programme varied seasonally, 24,3% of all patients prescribed an ACT had a negative RDT or were never administered an RDT, and less than half of patients with absolute indications for referral (severe symptoms, age under two months and pregnancy) were referred. There were few stock-outs.DiscussionThis CCMm programme successfully increased the number of patients with access to RDT and ACT, but further investigation is required to identify the cause for over-prescription, and low rates of referrals for patients with absolute indications. In contrast, previous widespread stock-outs in Saraya’s CCMm programme have now been resolved.ConclusionThis study demonstrates the potential for CCMm programmes to substantially increase access to life-saving malarial diagnostics and treatment, but also highlights important challenges in ensuring quality.

【 授权许可】

CC BY   
© Ndiaye et al.; licensee BioMed Central Ltd. 2013