Malaria rapid testing by community health workers is effective and safe for targeting malaria treatment: Randomised cross-over trial in Tanzania

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dc.contributor.author Janson, A.
dc.contributor.author Mubi, M.
dc.contributor.author Warsame, M.
dc.contributor.author Ma°rtensson, A.
dc.contributor.author Ka¨ llander, K.
dc.contributor.author Petzold, M.G
dc.contributor.author Ngasala, B.
dc.contributor.author Maganga, G.
dc.contributor.author Gustafsson, L.L
dc.contributor.author Massele, A.
dc.contributor.author Tomson, G.
dc.contributor.author Premji, Z.
dc.contributor.author Bjo¨rkman, A.
dc.date.accessioned 2013-02-08T08:39:32Z
dc.date.available 2013-02-08T08:39:32Z
dc.date.issued 2011
dc.identifier.citation Mubi, M., Janson, A., Warsame, M., Mårtensson, A., Källander, K., Petzold, M. G., ... & Björkman, A. (2011). Malaria rapid testing by community health workers is effective and safe for targeting malaria treatment: randomised cross-over trial in Tanzania. PloS one, 6(7), e19753.
dc.identifier.issn journal.pone.0019753
dc.identifier.uri http://hdl.handle.net/123456789/223
dc.description.abstract Background: Early diagnosis and prompt, effective treatment of uncomplicated malaria is critical to prevent severe disease, death and malaria transmission. We assessed the impact of rapid malaria diagnostic tests (RDTs) by community health workers (CHWs) on provision of artemisinin-based combination therapy (ACT) and health outcome in fever patients. Methodology/Principal Findings: Twenty-two CHWs from five villages in Kibaha District, a high-malaria transmission area in Coast Region, Tanzania, were trained to manage uncomplicated malaria using RDT aided diagnosis or clinical diagnosis (CD) only. Each CHW was randomly assigned to use either RDT or CD the first week and thereafter alternating weekly. Primary outcome was provision of ACT and main secondary outcomes were referral rates and health status by days 3 and 7. The CHWs enrolled 2930 fever patients during five months of whom 1988 (67.8%) presented within 24 hours of fever onset. ACT was provided to 775 of 1457 (53.2%) patients during RDT weeks and to 1422 of 1473 (96.5%) patients during CD weeks (Odds Ratio (OR) 0.039, 95% CI 0.029–0.053). The CHWs adhered to the RDT results in 1411 of 1457 (96.8%, 95% CI 95.8–97.6) patients. More patients were referred on inclusion day during RDT weeks (10.0%) compared to CD weeks (1.6%). Referral during days 1–7 and perceived non-recovery on days 3 and 7 were also more common after RDT aided diagnosis. However, no fatal or severe malaria occurred among 682 patients in the RDT group who were not treated with ACT, supporting the safety of withholding ACT to RDT negative patients. Conclusions/Significance: RDTs in the hands of CHWs may safely improve early and well-targeted ACT treatment in malaria patients at community level in Africa. en_GB
dc.language.iso en en_GB
dc.publisher Mubi en_GB
dc.relation.ispartofseries PLoS ONE;6(7): e19753.
dc.subject Malaria Treatment en_GB
dc.subject Community Health Workers en_GB
dc.subject Tanzania en_GB
dc.title Malaria rapid testing by community health workers is effective and safe for targeting malaria treatment: Randomised cross-over trial in Tanzania en_GB
dc.type Article en_GB


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