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Community-Level Management of Unclassified Fever

Universal versus conditional three-day follow up visit for children with uncomplicated fever at the community level: design of a cluster randomized, community-based, non-inferiority trial in Tanganyika, Democratic Republic of Congo

The current recommendation within Integrated Community Case Management guidelines that all children presenting with uncomplicated fever and no danger signs be followed up after three days may not be necessary. Such fevers often resolve rapidly (usually 48-96 h), and previous studies suggest that expectant home care for uncomplicated fever can be safely recommended. We aim to determine the non-inferiority of a conditional versus a universal follow-up visit fort these children.

Comparing actual and perceived causes of fever among community members in a low malaria transmission setting in northern Tanzania

The purpose of this paper was to compare actual and perceived causes of fever in northern Tanzania. In a standardized survey, heads of households in 30 wards in Moshi, Tanzania, were asked to identify the most common cause of fever for children and for adults. Responses were compared to data from a local hospital-based fever etiology study that used standard diagnostic techniques. Malaria was the most frequently identified cause of fever, cited by 56.7% and 43.6% as the most common cause of fever for adults and children, respectively.

Beyond Malaria — Causes of Fever in Outpatient Tanzanian Children

As the incidence of malaria diminishes, a better understanding of nonmalarial fever is important for effective management of illness in children. In this study, we explored the spectrum of causes of fever in African children. Researchers recruited children younger than 10 years of age with a temperature of 38°C or higher at two outpatient clinics — one rural and one urban — in Tanzania. Medical histories were obtained and clinical examinations conducted by means of systematic procedures.

Integrated Community Case Management of Fever in Children under Five Using Rapid Diagnostic Tests and Respiratory Rate Counting: A Multi-Country Cluster Randomized Trial

Evidence on the impact of using diagnostic tests in community case management of febrile children is
limited. This effectiveness trial conducted in Burkina Faso, Ghana, and Uganda, compared a diagnostic and treatment
package for malaria and pneumonia with presumptive treatment with anti-malarial drugs; artemisinin combination
therapy (ACT). We enrolled 4,216 febrile children between 4 and 59 months of age in 2009–2010. Compliance with the
malaria rapid diagnostic test (RDT) results was high in the intervention arm across the three countries, with only 4.9%

Quality and safety of integrated community case management of malaria using rapid diagnostic tests and pneumonia by community health workers

The objective was to assess the quality and safety of having community health workers (CHWs) in rural Zambia use rapid diagnostic tests (RDTs) and provide integrated management of malaria and pneumonia. In the context of a cluster-randomized controlled trial of two models for community-based management of malaria and/or non-severe pneumonia in children under 5 years old, CHWs in the intervention arm were trained to use RDTs, follow a simple algorithm for classification and treat malaria with artemether–lumefantrine (AL) and pneumonia with amoxicillin.

Addressing inequity to achieve the maternal and child health millennium development goals: looking beyond averages

Inequity in access to and use of child and maternal health interventions is impeding progress towards the maternal and child health Millennium Development Goals. This study explores the potential health gains and equity impact if a set of priority interventions for mothers and under fives were scaled up to reach national universal coverage targets for MDGs in Tanzania. Researchers used the Lives Saved Tool (LiST) to estimate potential reductions in maternal and child mortality and the number of lives saved across wealth quintiles and between rural and urban settings.

Karin Kallander

Karin Kallander

Principal Investigator
Karolinska Institute
Stockholm, Sweden

Since April 2015, Karin Kallander, PhD has served as the Principal Investigator on a TRAction-funded study focused on improving the community-level management of children with unclassified fever in Ethiopia.

Luke Mullany

Luke Mullany

Assessing the impact of integrated community case management (iCCM) programs on child mortality: Review of early results and lessons learned in sub–Saharan Africa

To accelerate progress in reducing child mortality, many countries in sub–Saharan Africa have adopted and scaled–up integrated community case management (iCCM) programs targeting the three major infectious killers of children under–five. The programs train lay community health workers to assess, classify and treat uncomplicated cases of pneumonia with antibiotics, malaria with antimalarial drugs and diarrhea with Oral Rehydration Salts (ORS) and zinc.

Community-Level Management of Unclassified Fever

Research Overview

TRAction is currently funding a research study in Ethiopia to explore the safety of a systematic versus conditional 3-day follow up visit by a community health worker (CHW) for children with uncomplicated fever.



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