Impact of Improving Community-Based Access to Malaria Diagnosis and Treatment on Household Costs

Joelle Castellani*, Jesca Nsungwa-Sabiiti, Borislava Mihaylova, IkeOluwapo O. Ajayi, Mohamadou Siribie, Chinenye Afonne, Andrew Balyeku, Luc Serme, Armande K. Sanou, Benjamin S. Sombie, Alfred B. Tiono, Sodiomon B. Sirima, Vanessa Kabarungi, Catherine O. Falade, Josephine Kyaligonza, Silvia M. A. A. Evers, Agnes Paulus, Max Petzold, Jan Singlovic, Melba Gomes

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background. Community health workers (CHWs) were trained in Burkina Faso, Nigeria, and Uganda to diagnose febrile children using malaria rapid diagnostic tests, and treat positive malaria cases with artemisinin-based combination therapy (ACT) and those who could not take oral medicines with rectal artesunate. We quantified the impact of this intervention on private household costs for childhood febrile illness. Methods. Households with recent febrile illness in a young child in previous 2 weeks were selected randomly before and during the intervention and data obtained on household costs for the illness episode. Household costs included consultation fees, registration costs, user fees, diagnosis, bed, drugs, food, and transport costs. Private household costs per episode before and during the intervention were compared. The intervention's impact on household costs per episode was calculated and projected to districtwide impacts on household costs. Results. Use of CHWs increased from 35% of illness episodes before the intervention to 50% during the intervention (P
Original languageEnglish
Pages (from-to)S256-S263
JournalClinical Infectious Diseases
Volume63
DOIs
Publication statusPublished - 15 Dec 2016

Keywords

  • CHW
  • economics
  • access
  • ACTs
  • malaria

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