Trial on malaria management underway at Prampram

Saturday, May 10, 2008 (The Mirror Pg 34)
By Rebecca Kwei
A community-based trial to find out the impact of home and community management of malaria and pneumonia in children under-five is being undertaken in the Dangme West district.
Under the study, children with fever are given an anti malarial and antibiotic combination by community based agents (CBAs) to ascertain its impact on illness and death rates in children under five.
This was made known when about 20 journalists from various media houses in Accra visited Prampram to acquaint themselves with research work on malaria in the district.
The programme was organised by the African Media and Malaria Research Network (AMMREN) as part of activities marking World Malaria Day, in collaboration with The Malaria Clinical Trials Alliance (MCTA), the Malaria Consortium, Mozambique, and Indepth Network.
Giving a background to the study, Dr Amanua Chinbuah, a Public Health Specialist said research findings show that most deaths in children often occur at home before reaching health facilities and that was a major implication for programmes intending to reduce child mortality.
She said, in order to save lives, there was the need for children to be promptly diagnosed and offered effective treatment at home/community level before reaching health facilities.
Dr Chinbuah said overall childhood mortality remains high in Ghana despite various strategies aimed at combating malaria as well as other preventable childhood illnesses.
Currently the Ghana Health Service policy is to treat presumptively fever in a child under five as having malaria.
However, she noted that not all fevers in under-fives were due to malaria. The three major childhood illnesses causing death in Africa were malaria, acute respiratory infections especially pneumonia and diarrhoea. Additionally, Dr Chinbuah said some symptoms that occur in malaria also occur in pneumonia making it difficult to easily distinguish between these two diseases even in health institutions where there are no laboratory facilities.
The overall objective of the study was thus, to develop and test the impact of an intervention for home management of fever (presumably due to malaria and pneumonia) that is feasible and acceptable on under-five mortality and morbidity.
Home Based Management of Malaria which was later changed to Home Based Management of Fever (HBMF) was initiated by the World Health Organisation is the process by which fever in children under five years recognised by their caregivers is treated at home or in the communities by their caregivers, and or community health workers or trained medicine distributors.
For this trial, CBAs have been trained among others to determine the eligibility for treatment, assess, classify and identify treatment, treat and refer where necessary as well as record keeping. The anti malarial drug used is artesunate amodiaquine and the antibiotic is amoxicillin.
The communities in which the CBAs work have also been sensitised through audio messages, dramas and are allowed to ask questions on the intervention being introduced.
According to Dr Chinbuah, the project was still in its implementation stage and the 600 CBAs who have been trained have taken care of more than 3000 children with fevers in the district.
She said the field supervisors will continue to monitor the CBAs, adverse drug events, drug resistance patterns as well as review changes in caregiver knowledge and behaviour.