Project Abstract

Abstract
Childhood malaria remains a significant public health concern, particularly in resource-limited settings where access to healthcare services is limited. This study aimed to evaluate the feasibility and effectiveness of a community-based approach for the diagnosis and management of childhood malaria using rapid diagnostic tests (RDTs) and treatment with artemisinin-based combination therapy (ACT). A community-based diagnosis and management strategy were implemented in a rural setting with limited access to healthcare facilities. Community health workers were trained to use RDTs to diagnose malaria in children presenting with fever. Positive cases were then treated with ACT following national treatment guidelines. The impact of this strategy on malaria diagnosis and treatment outcomes, as well as on the burden of malaria in the community, was assessed. The results showed that the community-based approach using RDTs for malaria diagnosis was feasible and effective in this setting. Community health workers demonstrated high levels of competency in performing RDTs and interpreting the results accurately. The use of RDTs also led to a significant increase in the proportion of children with fever who received a malaria diagnosis compared to standard clinical diagnosis. Furthermore, the prompt treatment of RDT-positive cases with ACT was associated with improved treatment outcomes. Children who received ACT within the recommended time frame showed faster resolution of symptoms and lower rates of treatment failure compared to those who were treated based on clinical suspicion alone. Overall, the community-based approach for the diagnosis and management of childhood malaria using RDTs and ACT was found to be a cost-effective and sustainable strategy for improving malaria control in resource-limited settings. By decentralizing malaria diagnosis and treatment to the community level, this approach can help increase access to timely and appropriate care for children with malaria, ultimately reducing the burden of the disease in affected communities. In conclusion, community-based diagnosis and management of childhood malaria using RDTs and ACT have the potential to enhance the effectiveness of malaria control programs and contribute to the global efforts to eliminate malaria as a public health threat. Further research is needed to evaluate the scalability and long-term sustainability of this approach in diverse settings.

Project 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%