Improved Clinical and Microscopy Diagnosis at Primary Health Care in Tanzania

Study Overview
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Brief Summary
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General objective: To improve the quality of fever case management in children in government health facilities in Tanzania Hypothesis:The training of health workers, as well as provision, training and use of microscopes for malaria diagnosis will improve the treatment of clinical episodes of fever in children while reducing the amount and costs of drugs

Detailed Description
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PHC facilities were eligible for the study if they were rural government owned; accessible by road during rainy season; and within 3 hours by car from Muhimbili University College of Health Sciences (MUCHS), Dar es Salaam All children attending the 16 PHC facilities under the study during daytime were enrolled if they fulfilled the following criteria: below five years of age fever (temperature≥37.5◦C) and/or reported history of fever in last 2 days able to return to the facility on day 7 after treatment or any other day if symptoms were to worsen or recur the mother/guardian or caretaker consented to participate. Patients with severe disease and/or general danger signs requiring inpatient care according to the IMCI guidelines were admitted or referred to the health centers or the district hospitals

Official Title
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Quality Malaria Case Management In Under- Fives In Primary Health Care (Phc) Institutions In Bagamoyo And Kibaha Districts Of Coastal Tanzania:a Multicomponent Controlled Intervention Study

Conditions
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Malaria

Intervention / Treatment
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* Procedure: Clinical algorithm and microscopy diagnosis of malaria


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: below five years of age fever (temperature≥37.5◦C) and/or reported history of fever in last 2 days able to return to the facility on day 7 after treatment or any other day if symptoms were to worsen or recur the mother/guardian or caretaker consented to participate Exclusion Criteria: a) N/A

Ages Eligible for Study
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Minimum Age: 6 Months
Maximum Age: 59 Months

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 1<br>training in clinical algorithm plus microscopy | Procedure: Clinical algorithm and microscopy diagnosis of malaria<br>* Clinical alogarithm The content of the package included description of signs and symptoms of malaria disease history taking relevant to malaria and physical examination identification of danger signs and severe illness for referral appropriate treatment counseling patients on the use of drugs. Malaria microscopy. contents make thick blood smears from patients with fever and stain with Giemsa identify and count malaria parasites maintain the microscope and store blood slides.<br>|
| Experimental: 2<br>clinical algorithm | Procedure: Clinical algorithm and microscopy diagnosis of malaria<br>* Clinical alogarithm The content of the package included description of signs and symptoms of malaria disease history taking relevant to malaria and physical examination identification of danger signs and severe illness for referral appropriate treatment counseling patients on the use of drugs. Malaria microscopy. contents make thick blood smears from patients with fever and stain with Giemsa identify and count malaria parasites maintain the microscope and store blood slides.<br>|
| No Intervention: 3<br>Control | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| the proportion of study children receiving prescriptions of antimalarial drugs in the respective arms |  | Day 0 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| prescriptions of antibiotics, cost of drugs |  | Day 0 | 
| health outcome of the patients |  | Day 1-6, day 7 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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malaria microscopy primary health care children