Impact of home-based management of malaria on health outcomes in Africa: a systematic review of the evidence
Abstract Background Home-based management of malaria (HMM) is promoted as a major strategy to improve prompt delivery of effective malaria treatment in Africa. HMM involves presumptively treating febrile children with pre-packaged antimalarial drugs distributed by members of the community. HMM has b...
Published in: | Malaria Journal |
---|---|
Main Authors: | , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
BMC
2007
|
Subjects: | |
Online Access: | https://doi.org/10.1186/1475-2875-6-134 https://doaj.org/article/d84d1054e15f45ffb6ef59c08f1ea3d0 |
id |
ftdoajarticles:oai:doaj.org/article:d84d1054e15f45ffb6ef59c08f1ea3d0 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:d84d1054e15f45ffb6ef59c08f1ea3d0 2023-05-15T15:14:57+02:00 Impact of home-based management of malaria on health outcomes in Africa: a systematic review of the evidence Whitty Christopher JM Talisuna Ambrose Hopkins Heidi Staedke Sarah G 2007-10-01T00:00:00Z https://doi.org/10.1186/1475-2875-6-134 https://doaj.org/article/d84d1054e15f45ffb6ef59c08f1ea3d0 EN eng BMC http://www.malariajournal.com/content/6/1/134 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-6-134 1475-2875 https://doaj.org/article/d84d1054e15f45ffb6ef59c08f1ea3d0 Malaria Journal, Vol 6, Iss 1, p 134 (2007) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2007 ftdoajarticles https://doi.org/10.1186/1475-2875-6-134 2022-12-31T08:11:26Z Abstract Background Home-based management of malaria (HMM) is promoted as a major strategy to improve prompt delivery of effective malaria treatment in Africa. HMM involves presumptively treating febrile children with pre-packaged antimalarial drugs distributed by members of the community. HMM has been implemented in several African countries, and artemisinin-based combination therapies (ACTs) will likely be introduced into these programmes on a wide scale. Case presentations The published literature was searched for studies that evaluated the health impact of community- and home-based treatment for malaria in Africa. Criteria for inclusion were: 1) the intervention consisted of antimalarial treatment administered presumptively for febrile illness; 2) the treatment was administered by local community members who had no formal education in health care; 3) measured outcomes included specific health indicators such as malaria morbidity (incidence, severity, parasite rates) and/or mortality; and 4) the study was conducted in Africa. Of 1,069 potentially relevant publications identified, only six studies, carried out over 18 years, were identified as meeting inclusion criteria. Heterogeneity of the evaluations, including variability in study design, precluded meta-analysis. Discussion and evaluation All trials evaluated presumptive treatment with chloroquine and were conducted in rural areas, and most were done in settings with seasonal malaria transmission. Conclusions regarding the impact of HMM on morbidity and mortality endpoints were mixed. Two studies showed no health impact, while another showed a decrease in malaria prevalence and incidence, but no impact on mortality. One study in Burkina Faso suggested that HMM decreased the proportion of severe malaria cases, while another study from the same country showed a decrease in the risk of progression to severe malaria. Of the four studies with mortality endpoints only one from Ethiopia showed a positive impact, with a reduction in the under-5 mortality rate of ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 6 1 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Whitty Christopher JM Talisuna Ambrose Hopkins Heidi Staedke Sarah G Impact of home-based management of malaria on health outcomes in Africa: a systematic review of the evidence |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Home-based management of malaria (HMM) is promoted as a major strategy to improve prompt delivery of effective malaria treatment in Africa. HMM involves presumptively treating febrile children with pre-packaged antimalarial drugs distributed by members of the community. HMM has been implemented in several African countries, and artemisinin-based combination therapies (ACTs) will likely be introduced into these programmes on a wide scale. Case presentations The published literature was searched for studies that evaluated the health impact of community- and home-based treatment for malaria in Africa. Criteria for inclusion were: 1) the intervention consisted of antimalarial treatment administered presumptively for febrile illness; 2) the treatment was administered by local community members who had no formal education in health care; 3) measured outcomes included specific health indicators such as malaria morbidity (incidence, severity, parasite rates) and/or mortality; and 4) the study was conducted in Africa. Of 1,069 potentially relevant publications identified, only six studies, carried out over 18 years, were identified as meeting inclusion criteria. Heterogeneity of the evaluations, including variability in study design, precluded meta-analysis. Discussion and evaluation All trials evaluated presumptive treatment with chloroquine and were conducted in rural areas, and most were done in settings with seasonal malaria transmission. Conclusions regarding the impact of HMM on morbidity and mortality endpoints were mixed. Two studies showed no health impact, while another showed a decrease in malaria prevalence and incidence, but no impact on mortality. One study in Burkina Faso suggested that HMM decreased the proportion of severe malaria cases, while another study from the same country showed a decrease in the risk of progression to severe malaria. Of the four studies with mortality endpoints only one from Ethiopia showed a positive impact, with a reduction in the under-5 mortality rate of ... |
format |
Article in Journal/Newspaper |
author |
Whitty Christopher JM Talisuna Ambrose Hopkins Heidi Staedke Sarah G |
author_facet |
Whitty Christopher JM Talisuna Ambrose Hopkins Heidi Staedke Sarah G |
author_sort |
Whitty Christopher JM |
title |
Impact of home-based management of malaria on health outcomes in Africa: a systematic review of the evidence |
title_short |
Impact of home-based management of malaria on health outcomes in Africa: a systematic review of the evidence |
title_full |
Impact of home-based management of malaria on health outcomes in Africa: a systematic review of the evidence |
title_fullStr |
Impact of home-based management of malaria on health outcomes in Africa: a systematic review of the evidence |
title_full_unstemmed |
Impact of home-based management of malaria on health outcomes in Africa: a systematic review of the evidence |
title_sort |
impact of home-based management of malaria on health outcomes in africa: a systematic review of the evidence |
publisher |
BMC |
publishDate |
2007 |
url |
https://doi.org/10.1186/1475-2875-6-134 https://doaj.org/article/d84d1054e15f45ffb6ef59c08f1ea3d0 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 6, Iss 1, p 134 (2007) |
op_relation |
http://www.malariajournal.com/content/6/1/134 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-6-134 1475-2875 https://doaj.org/article/d84d1054e15f45ffb6ef59c08f1ea3d0 |
op_doi |
https://doi.org/10.1186/1475-2875-6-134 |
container_title |
Malaria Journal |
container_volume |
6 |
container_issue |
1 |
_version_ |
1766345344804716544 |