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Clin Infect Dis. 2016 Dec 15;63(suppl 5):S283-S289.

Compliance With Referral Advice After Treatment With Prereferral Rectal Artesunate: A Study in 3 Sub-Saharan African Countries.

Author information

1
Groupe de Recherche Action en Santé, Ouagadougou, Burkina Faso.
2
Department of Epidemiology and Medical Statistics, College of Medicine.
3
Child Health Division, Ministry of Health, Kampala, Uganda.
4
Department of Sociology, Faculty of Social Sciences.
5
Epidemiology and Biostatistics Research Unit, Institute of Advanced Medical Research and Training.
6
Department of Pharmacology and Therapeutics, College of Medicine, University of Ibadan, Nigeria.
7
UNICEF/UNDP/World Bank/WHO/Special Programme for Research & Training in Tropical Diseases, World Health Organization, Geneva, Switzerland.

Abstract

BACKGROUND:

 Children aged <5 years were enrolled in a large study in 3 countries of sub-Saharan Africa because they had danger signs preventing them from being able to take oral medications. We examined compliance and factors associated with compliance with referral advice for those who were treated with rectal artesunate.

METHODS:

 Patient demographic data, speed of accessing treatment after danger signs were recognized, clinical symptoms, malaria microscopy, treatment-seeking behavior, and compliance with referral advice were obtained from case record forms of 179 children treated with prereferral rectal artesunate in a multicountry study. We held focus group discussions and key informant interviews with parents, community health workers (CHWs), and facility staff to understand the factors that deterred or facilitated compliance with referral advice.

RESULTS:

 There was a very high level of compliance (90%) among patients treated with prereferral rectal artesunate. Age, symptoms at baseline (prostration, impaired consciousness, convulsions, coma), and malaria status were not related to referral compliance in the analysis.

CONCLUSIONS:

 Teaching CHWs to diagnose and treat young children with prereferral rectal artesunate is feasible in remote communities of Africa, and high compliance with referral advice can be achieved.

KEYWORDS:

community health worker; compliance with referral advice; malaria; rapid diagnostic tests; rectal artesunate

PMID:
27941106
PMCID:
PMC5146699
DOI:
10.1093/cid/ciw627
[Indexed for MEDLINE]
Free PMC Article

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