Research and Reports in Tropical Medicine最新文献

{"title":"Infantile tremor syndrome: current perspectives","authors":"Rajesh Gupta, A. Rawat, Poonam Singh, Jyoti Gupta, A. Pathak","doi":"10.2147/RRTM.S180604","DOIUrl":"https://doi.org/10.2147/RRTM.S180604","url":null,"abstract":"Abstract Infantile Tremor Syndrome (ITS) is a self-limiting clinical state characterized by tremors, anemia, pigmentary skin disease, regression of mental development, and hypotonia of muscles in a plump looking child. Tremors are coarse in character, decreased or disappeared in sleep and resolves within 4–6 weeks in its natural course. Various etiological factors as infectious, metabolic, nutritional have been hypothesized but none is conclusive. Consensus is developing on the role of Vitamin B12 deficiency in children with ITS but is still debatable. Empirical management of ITS children has been tried in the absence of exact etiology considering child as undernourished. Nutritional management includes supplementation of Iron, Calcium, Magnesium, Vitamin B12 and other multivitamins. Tremors can be managed with administration of propranolol most commonly or phenobarbitone, phenytoin, and carbamazepine.","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"10 1","pages":"103 - 108"},"PeriodicalIF":3.1,"publicationDate":"2019-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S180604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45831156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of annual preventive mass chemotherapy for soil-transmitted helminths among primary school children in an endemic area of Gurage zone: a prospective cross-sectional study","authors":"Teha Shumbej, Sofia Menu, Tadele Girum, F. Bekele, Teklemichael Gebru, Meron Worku, Andamlak Dendir, Absra Solomon, Daniel Kahase, M. Alemayehu","doi":"10.2147/RRTM.S208473","DOIUrl":"https://doi.org/10.2147/RRTM.S208473","url":null,"abstract":"Background and aim School-based preventive mass chemotherapy has been a key component of Ethiopia's national plan for the control of soil-transmitted helminths. Without an impact evaluation on the impact of a deworming program on infection levels, it is unclear whether the deworming program warrants levels of environmental transmission of infection. This study aimed to determine the impact of annual preventive mass chemotherapy for soil-transmitted helminths among schoolchildren in an endemic area of Gurage zone, south-central Ethiopia. Methods A repeated school-based quantitative prospective cross-sectional method was employed. Data were collected from study participants selected using systematic sampling with probability proportional to size at baseline and after annual treatment. Fresh stool samples were collected and processed using the Kato─Katz technique at the Wolkite University parasitology laboratory. SPSS-21 was used for data management and analysis. Changes in parasitological variables after treatment were estimated. Results Overall, 41.1% prevalence and 22.3% mean geometric infection-intensity reduction were found. Reductions in prevalence of Schistosoma mansoni and hookworms were 13.2% and 15.3%, respectively. Similarly, decreases in prevalence were seen in Ascaris lumbricoides and Trichuris trichiura, representing 94.4% and 80.0% reduction rates, respectively, while 25.9% of the children had heavy S. mansoni (≥400 eggs per gram) infections at baseline, which were reduced to 4.5% after annual treatment. Geometric mean infection intensity–reduction rates for hookworms, A. lumbricoides, and T. trichiura were 80.8%, 20.2%, and 96.7%, respectively. Conclusion Annual mass chemotherapy failed to clear soil-transmitted helminths completely in the present study. However, it resulted in a substantial reduction in overall prevalence and infection intensity. Therefore, other than deworming for school children, interventions such as access to improved personal hygiene and environmental hygiene in school should be emphasized to interrupt transmission.","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"10 1","pages":"109 - 118"},"PeriodicalIF":3.1,"publicationDate":"2019-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S208473","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43159240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epilepsy diagnosis and management of children in Kenya: review of current literature.","authors":"Pauline Samia, Jane Hassell, Jessica-Anne Hudson, Maureen Kanana Murithi, Symon M Kariuki, Charles R Newton, Jo M Wilmshurst","doi":"10.2147/RRTM.S201159","DOIUrl":"10.2147/RRTM.S201159","url":null,"abstract":"<p><p><b>Introduction:</b> The growing impact of non-communicable diseases in low- to middle-income countries makes epilepsy a key research priority. We evaluated peer-reviewed published literature on childhood epilepsy specific to Kenya to identify knowledge gaps and inform future priorities. <b>Methodology:</b> A literature search utilizing the terms \"epilepsy\" OR \"seizure\" as exploded subject headings AND \"Kenya\" was conducted. Relevant databases were searched, generating 908 articles. After initial screening to remove duplications, irrelevant articles, and publications older than 15 years, 154 papers remained for full-article review, which identified 35 publications containing relevant information. Data were extracted from these reports on epidemiology, etiology, clinical features, management, and outcomes. <b>Results:</b> The estimated prevalence of lifetime epilepsy in children was 21-41 per 1,000, while the incidence of active convulsive epilepsy was 39-187 cases per 100,000 children per year. The incidence of acute seizures was 312-879 per 100,000 children per year and neonatal seizures 3,950 per 100,000 live births per year. Common risk factors for both epilepsy and acute seizures included adverse perinatal events, meningitis, malaria, febrile seizures, and family history of epilepsy. Electroencephalography abnormalities were documented in 20%-41% and neurocognitive comorbidities in more than half. Mortality in children admitted with acute seizures was 3%-6%, and neurological sequelae were identified in 31% following convulsive status epilepticus. Only 7%-29% children with epilepsy were on antiseizure medication. <b>Conclusion:</b> Active convulsive epilepsy is a common condition among Kenyan children, remains largely untreated, and leads to extremely poor outcomes. The high proportion of epilepsy attributable to preventable causes, in particular neonatal morbidity, contributes significantly to the lifetime burden of the condition. This review reaffirms the ongoing need for better public awareness of epilepsy as a treatable disease and for national-level action that targets both prevention and management.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"10 1","pages":"91-102"},"PeriodicalIF":3.1,"publicationDate":"2019-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6607977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68479699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping and monitoring for a lymphatic filariasis elimination program: a systematic review.","authors":"Adinarayanan Srividya,&nbsp;Swaminathan Subramanian,&nbsp;Purushothaman Jambulingam,&nbsp;Balakrishnan Vijayakumar,&nbsp;Jeyapal Dinesh Raja","doi":"10.2147/RRTM.S134186","DOIUrl":"https://doi.org/10.2147/RRTM.S134186","url":null,"abstract":"<p><p>Lymphatic filariasis (LF) is targeted for elimination by the year 2020. The Global Programme for Elimination of LF (GPELF) aims to achieve elimination by interrupting transmission through annual mass drug administration (MDA) of albendazole with ivermectin or diethylcarbamazine. The program has successfully eliminated the disease in 11 of the 72 endemic countries, putting in enormous efforts on systematic planning and implementation of the strategy. Mapping areas endemic for LF is a pre-requisite for implementing MDA, monitoring and evaluation are the components of programme implementation. This review was undertaken to assess how the mapping and impact monitoring activities have evolved to become more robust over the years and steered the LF elimination programme towards its goal. The findings showed that the WHO recommended mapping strategy aided 17 countries to delimit, plan and implement MDA in only those areas endemic for LF thereby saving resources. Availability of serological tools for detecting infection in humans (antigen/antibody assays) and molecular xenomonitoring (MX) in vectors greatly facilitated programme monitoring and evaluation in endemic countries. Results of this review are discussed on how these existing mapping and monitoring procedures can be used for re-mapping of unsurveyed and uncertain areas to ensure there is no resurgence during post-MDA surveillance. Further the appropriateness of the tests (Microfilaria (Mf)/antigenemia (Ag)/antibody(Ab) surveys in humans or MX of vectors for infection) used currently for post-MDA surveillance and their role in the development of a monitoring and evaluation strategy for the recently WHO recommended triple drug regimen in MDA for accelerated LF elimination are discussed.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"10 ","pages":"43-90"},"PeriodicalIF":3.1,"publicationDate":"2019-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S134186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37362431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of hookworm and <i>Opisthorchis viverrini</i> infection among adolescents in urban Laos: a cross-sectional study.","authors":"Itsuko Yoshida,&nbsp;Osamu Horie,&nbsp;Kongsap Akkhavong","doi":"10.2147/RRTM.S199577","DOIUrl":"https://doi.org/10.2147/RRTM.S199577","url":null,"abstract":"<p><p><b>Purpose:</b> Infection with hookworm and <i>Opisthorchis viverrini</i> are serious health problems among children and adolescents in Laos. In this study, we demonstrated the factors related to hookworm and <i>O. viverrini</i> infection, including primary school health programs, among secondary school students in Vientiane city of Laos. <b>Material and methods:</b> A cross-sectional survey and stool examination were conducted among secondary school students in Vientiane. One stool sample from each participant was examined using two Kato-Katz smears. Data of 164 participants were analyzed and the associations among parasitic infections, sociodemographic characteristics, and the school health program in primary school were assessed in a univariate logistic regression analysis. Predictors with <i>p</i><0.25 were retained in a multivariate logistic regression model. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported. The significance level was set at <i>p</i><0.05. <b>Results:</b> The infection rates of <i>O. viverrini</i> and hookworm were 39.0% and 36.0%, respectively. Older students (OR=1.55, 95% CI: 1.01-2.37, <i>p</i>=0.046) and those whose father had irregular income (OR=0.47, 95% CI: 0.13-0.93, <i>p</i>=0.036) had a higher risk for hookworm infection. Students whose mother had irregular income (OR=0.30, 95% CI: 0.13-0.69, <i>p</i>=0.005) had a higher risk for <i>O. viverrini</i> infection. Higher primary school health program scores were associated with a lower risk for hookworm infection in the univariate model but not in the multivariate model. <b>Conclusion:</b> Sociodemographic factors have a strong influence on infections with both hookworm and <i>O. viverrini</i>. Current school health programs in Laos may be insufficient to reduce <i>O. viverrini</i> infections. Other approaches, such as supporting parents in finding employment with regular income, may be needed.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"10 ","pages":"31-41"},"PeriodicalIF":3.1,"publicationDate":"2019-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S199577","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37326810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of intestinal parasites and its risk factors among food handlers in food services in Nekemte town, west Oromia, Ethiopia.","authors":"Legesse Eshetu,&nbsp;Regea Dabsu,&nbsp;Geletta Tadele","doi":"10.2147/RRTM.S186723","DOIUrl":"https://doi.org/10.2147/RRTM.S186723","url":null,"abstract":"<p><strong>Background: </strong>Food-borne diseases are a public-health problem in developed and developing countries. The World Health Organization (WHO) estimated that in developed countries, up to 30% of the population suffers from food borne diseases each year and more in developing countries, where up to 2 million deaths are estimated per years.</p><p><strong>Objective: </strong>To assess the prevalence of intestinal parasites and its associated risk factors among food handlers in Nekemte town.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in Nekemte from April to May, 2016. A total of 240 food handlers were selected using a simple random-sampling technique from hotels, bars, and restaurants. Data were collected using pretested questions and stool-specimen examination for intestinal parasites. For intestinal parasites, stool-sample examinations were done using wet-mount and concentration methods. Data analysis was done using SPSS version 20. Associations among intestinal parasites and risk factors were determined using logistic regression and <i>P</i><0.05 considered significant.</p><p><strong>Results: </strong>The prevalence of intestinal parasites in this study was 52.1%. <i>Entamoeba histolytica</i>/<i>dispar</i> was the most predominant parasite (56.8%), followed by <i>Ascaris lumbricoides</i> (26.4%), <i>Taenia saginata</i> (16%), and hookworm (16.8%). Hygienic practice such as hand washing after toilet by water, hand washing after toilet by water and soap, trimming of finger nail, wearing proper working clothes and shoes were statistically significant with intestinal parasitic infection if not regularly performed (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>The prevalence of intestinal parasites in this study was high, with single double, and triple infection. Food handlers should practice safe food preparation and food service to reduce the probability of intestinal parasite infection.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"10 ","pages":"25-30"},"PeriodicalIF":3.1,"publicationDate":"2019-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S186723","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37326809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fruit and vegetable contamination with medically important helminths and protozoans in Tarcha town, Dawuro zone, South West Ethiopia.","authors":"Fitsum Bekele,&nbsp;Teha Shumbej","doi":"10.2147/RRTM.S205250","DOIUrl":"https://doi.org/10.2147/RRTM.S205250","url":null,"abstract":"<p><p><b>Background:</b> Fresh vegetables supply the body with essential supplements. The consumption of raw vegetables and fruits are among the ways for transmission of intestinal parasitic organisms to human beings. This study was aimed at detecting the parasitic contamination in fresh vegetables sold at the central open-aired market of Tarcha town, Ethiopia. <b>Methods:</b> A total of 270 fresh vegetables and fruit samples were collected from the main market of Tarcha town during August 1, 2017-August 22, 2017. The samples were microscopically examined for detection of medically important parasites after washing with 500 mL normal saline and 24-hr sedimentation of the washing solution followed by centrifuging at 2000 g for 5 mins. After centrifugation, the supernatant was decanted leaving the sediment. Finally, the sediment was examined under a light microscope for protozoans and helminths worms. <b>Results:</b> Of the 270 fresh vegetable and fruit samples, 115 (42.6%) were found positive for intestinal parasites. A high level of contamination in fresh vegetable and fruit samples was recorded in cabbage 71.1% (32/45) while tomato was the least contaminated 24.4% (11/45). The identified medically important parasites were <i>Entamoeba histolytica/dispar, Giardia intestinalis, Ascaris lumbricoides, Hymenolepis nana, Toxocara</i> spp, <i>Hymenolepis diminuta,</i> and <i>Cystoisospora belli</i>. The most predominant parasite encountered was <i>Ascaris lumbricoides</i> (16.7%) whereas <i>Cystoisospora belli</i> (2.6%<i>)</i> the least detected. All of the vegetables and fruits that were contaminated were with more than one parasite species. A statistically significant association between the type of vegetables and the presence of parasites was also observed (<i>p</i>=0.002). <b>Conclusion:</b> This study has shown that fruits and vegetables which are sold in the study area are highly contaminated with medically important parasites. Fruits and vegetables sold in the study area may play a role in the transmission of intestinal parasitic infections to humans. Effective and comprehensive prevention measures should be taken to ensure food safety. Relevant bodies should work on addressing the issue of high rate of vegetable and fruit contamination in the study area.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"10 ","pages":"19-23"},"PeriodicalIF":3.1,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S205250","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37002912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipsosomal amphotericin B: a review of its properties, function, and use for treatment of cutaneous leishmaniasis.","authors":"Mohammad Reza Shirzadi","doi":"10.2147/RRTM.S200218","DOIUrl":"https://doi.org/10.2147/RRTM.S200218","url":null,"abstract":"<p><p>The genus <i>Leishmania</i> includes a number of protozoan parasites that cause a wide range of infections named leishmaniasis. Leishmaniasis may be appear in three clinical forms - cutaneous (CL), visceral, and mucocutaneous (MCL) - with variation in their presentation and severity: diffuse CL and post-kala-azar dermal leishmaniasis). The prevalent signs of CL are nonhealing ulcers on exposed skin, but infected patients may have other dermatologic symptoms. In the 1960s, amphotericin B deoxycholate was introduced as a second-line therapy for CL and MCL. However, widespread administration of the agent was prevented, due to its renal and systemic toxicity, high price, and obstacles to intravenous use in leishmaniasis-endemic regions. Amphotericin B binds to ergosterol in the photogenic cell membranes and causes changes in membrane permeability, leakage of ions, and finally cell death. Compared to amphotericin B deoxycholate, a higher dose of liposomal amphotericin B should be administered to show the treatment effect. A high percentage of liposomal amphotericin B is \"fastened\" in the liposome and not biologically effective. Amphotericin B deoxycholate has some toxic effects, and liposomal amphotericin B is meaningfully less toxic compared to it. Treatment options for CL are limited, due to variation in species causing CL and pharmacokinetic issues. Amphotericin B is effective against some particular forms of CL.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"10 ","pages":"11-18"},"PeriodicalIF":3.1,"publicationDate":"2019-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S200218","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37002911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health literacy and knowledge related to tuberculosis among outpatients at a referral hospital in Lima, Peru.","authors":"Rosalina Penaloza,&nbsp;Joanna Itzel Navarro,&nbsp;Pauline E Jolly,&nbsp;Anna Junkins,&nbsp;Carlos Seas,&nbsp;Larissa Otero","doi":"10.2147/RRTM.S189201","DOIUrl":"10.2147/RRTM.S189201","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) case detection in Peru relies on passive case finding. This strategy relies on the assumption that the community is aware that a persistent cough or contact with a TB patient is an indication to seek formal health care. This study evaluated health literacy and TB knowledge among outpatients at Hospital Cayetano Heredia in Lima, Peru.</p><p><strong>Methods: </strong>A cross-sectional survey was performed between June and August 2017. Data on sociodemographic factors, TB knowledge, and health literacy were collected, and bivariate and multivariate logistic regressions were performed to study the associations between variables.</p><p><strong>Results: </strong>The analysis included 272 participants; 57.7% knew someone who had TB and 9% had TB in the past. A 2-week cough was reported as a TB symptom by 66 (24%) participants. High TB knowledge was found among 149 (54.8%) participants and high health literacy was found among 193 (71.0%) participants. Health literacy and TB knowledge were not significantly associated (OR=0.9; 95% CI 0.5-1.5). After controlling for sex, age, district, education, health insurance, frequency of hospital visits, and previous TB diagnosis, high TB knowledge was associated with knowing someone with TB (aOR=2.7; 95% CI 1.6-4.7) and inversely associated with being a public transport driver (aOR=0.2; 95% CI 0.05-0.9). Not living in poverty was the single factor associated with high health literacy (aOR=3.8; 95% CI 1.6-8.9).</p><p><strong>Conclusion: </strong>Although TB knowledge was fair, 30% did not know that cough is a symptom of TB and >70% did not know being in contact with a TB patient is a risk factor for TB. Tailoring educational strategies to at-risk groups may enhance passive case detection especially among transport workers and TB contacts in Lima, Peru.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"10 ","pages":"1-10"},"PeriodicalIF":3.1,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S189201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37064195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving prompt access to malaria diagnostics and treatment in rural remote areas using financial benefit for community health workers in Kilosa district, Tanzania.","authors":"Daudi Omari Simba,&nbsp;Deodatus Kakoko,&nbsp;Tumaini Nyamhanga,&nbsp;Zakayo Mrango,&nbsp;Phare Mujinja","doi":"10.2147/RRTM.S172944","DOIUrl":"10.2147/RRTM.S172944","url":null,"abstract":"<p><strong>Purpose: </strong>Improving access to malaria treatment in rural remote areas remains a major challenge facing innovative strategies, such as Accredited Drug Dispensing Outlets (ADDOs) and Community Health Workers (CHWs) programs in Tanzania. This study tested the effectiveness of a financial benefit approach to motivate CHWs to improve prompt access to malaria treatment.</p><p><strong>Patients and methods: </strong>We applied a quasi-experimental study design in rural-remote areas in Kilosa district, Tanzania. Febrile children in selected intervention areas were provided access to malaria diagnostic and treatment at a minimal fee to CHWs and compared with non-intervention areas. We measured impact using difference in differences (DID) analysis.</p><p><strong>Results: </strong>At baseline, 870 children <5 years of age were recruited and 1,127 in post-intervention. The DID in prompt access to malaria diagnostics and treatment was 28.0% in favor of intervention. A net pre and post decrease (DID=24.1%) in seeking care from public facilities was observed, signifying decrease in workload. Incidentally, knowledge on malaria treatment increased in intervention area (DID 11%-21%).</p><p><strong>Conclusion: </strong>Using the financial benefit approach, CHWs were able to significantly improve prompt access to malaria diagnostics and treatment in rural remote areas. Scaling up of the strategy might speed up the pace toward achieving national target of accurate diagnosis and appropriate treatment by 80% in 2020.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"9 ","pages":"137-146"},"PeriodicalIF":3.1,"publicationDate":"2018-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S172944","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36721657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}