Thesis Abstract

Abstract
Malaria remains a major public health challenge, particularly in endemic regions where children are the most vulnerable population. This research project focuses on a community-based approach to the diagnosis and management of childhood malaria using rapid diagnostic tests (RDTs) and treatment with artemisinin-based combination therapy (ACT). The study aims to evaluate the effectiveness and feasibility of this approach in improving early diagnosis and treatment of malaria in children living in remote and underserved communities. The project will involve training community health workers (CHWs) in the use of RDTs for malaria diagnosis. CHWs will be stationed in selected communities to provide prompt testing for children presenting with fever, a common symptom of malaria. Positive cases will be promptly treated with ACT as per national guidelines. The project will also include community sensitization and education on the importance of early diagnosis and treatment of malaria. A key component of the study is the assessment of the impact of community-based diagnosis and management on malaria-related outcomes such as treatment seeking behavior, treatment adherence, and treatment success rates. Data will be collected on the number of children tested, the proportion of positive cases, and the timeliness of treatment initiation. Follow-up visits will be conducted to monitor treatment outcomes and assess any potential challenges or barriers to implementation. The study will employ a mixed-methods approach, combining quantitative data collection through structured surveys and qualitative data collection through focus group discussions and interviews with key stakeholders. This approach will provide a comprehensive understanding of the acceptability and effectiveness of the community-based approach in the local context. The findings from this research project are expected to contribute to the evidence base on community-based strategies for malaria control and management, particularly in resource-limited settings. If successful, the implementation of RDTs by CHWs at the community level could lead to earlier detection and treatment of malaria in children, ultimately reducing the burden of the disease and improving health outcomes in these vulnerable populations.

Thesis Overview

A cross-sectional study was conducted for fifteen (15) months (May, 2012 to July, 2013) to assess the efficacy of Rapid Diagnostic Test (RDT) in diagnosis followed by treatment of childhood malaria with Artemisinin -Based Combination Therapy (ACT) at community level in Benue State. A total of 840 symptomatic children aged two months to thirteen years were presented for diagnosis with RDT kits by care givers at the designated clinics and at community levels. The 656 RDT positive children recorded in this study were treated with Artesunate-Amodiaquine. Microscopic slides of the blood of all the children presented for RDT were equally prepared and examined. Another 333 symptomatic children aged 2 months to thirteen years served as control in one clinic. All positive cases were reviewed, seven days after drug administration. Three hundred and nine (309) RDT positive children were followed-up for adherence to treatment regime. Intradermal smear and peripheral blood films were prepared for 59 children previously confirmed to be positive and were examined after treatment. Semi-structured questionnaires were administered to determine the perception of malaria and treatment preference of community. An overall malaria community microscopic confirmatory prevalence of 87.7% was recorded for the children. RDT/community based study recorded a cure rate of 88.2% with a prevalence reduction from 78.1% to 11.8%