Table 1 Description of study sites and intervention implementation in four sites evaluating home management of malaria with artemisinin combination therapy
Ejisu – Juaben District, Ghana | Ho District, Ghana | Badeku and Ojoku/Ajia Districts, Nigeria | Bugiri and Iganga Districts, Uganda | |
|---|---|---|---|---|
Population characteristics | 35 rural communities Population c. 38,000 Perennial malaria transmission | 49 urban & rural communities Population c. 42,000 Perennial malaria transmission | 40 rural communities Population 43,000 Perennial, hyperendemic malaria transmission | 56 rural communities Population c. 60,000 Perennial, hyperendemic transmission |
Community medicine distributors | 54 (51 male) trusted members of community (farmers, teachers, drug sellers), chosen by the community | 76 (48 male) trusted members of community (farmers, teachers, drug sellers), chosen by the community | 60 (4 male) including drug sellers, health workers and mothers chosen by the communities | 118 (62 male) pre-existing cadre of CMDs (chosen by the community) |
5 days of training | 2 days of training | 2 days of training | 2 days of training | |
Provided with bicycles, boots & $3.50 monthly | Provided with T-shirts, watches, raincoats, torches & US$8 quarterly | Received commission of 20–30 US cents per pack distributed. Provided with T-shirts, transport reimbursement, Festivity gift, and certificates. | Transport refund of USD 1.16 per meeting. T-shirts, baseball caps, certificates | |
Bimonthly supervision by research staff; Monthly supervision by community Health Officers | Monthly supervision by health staff and quarterly meetings | Monthly supervision by research staff | Monthly supervision by health staff | |
CMDs were not obliged to follow up caregivers. However, some of them followed up and some gave drugs under direct observation. | No active follow-up of caregivers by CMDs. | Program ran within existing home management system. CMDs actively followed up treated children to establish treatment outcome | ||
Drugs and dosing schedule | Artesunate+Amodiaquine (ASAQ) once daily for 3 days 2 types of blister pack, for children < 1 year and children 1 year and above | Artemether-lumefantrine (Coartem®) twice daily for 3 days 2 types of blister pack, for children < 3 years and children 3 years and above | ||
10 US cents for <1 year 20 US cents for 1 year and above | 20 US cents for < 3 years 30 US cents for 3 years and above Charged for first 6 months only, thereafter free | Free | ||