Quality of Malaria Treatment Provided under ‘Better Health Together’ Project in Ethnic Communities of Myanmar: How Are We Performing?

Abstract

Malaria accounted for 18% of all deaths in the ethnic communities of Myanmar. In this cross-sectional study, we assessed the extent of and factors associated with receipt of quality malaria treatment services provided by integrated community malaria volunteer (ICMV) under six ethnic health organisations. Data of people with malaria diagnosed by rapid diagnostic tests during 2017–2018 were extracted from the ICMV registers. Documentation of prescribing a complete course of drugs was used to assess quality. Of 2881 people with malaria, village-based ICMV diagnosed and treated 2279 (79%) people. Overall, 2726 (95%) people received correct drugs in the correct dose and adequate duration appropriate to malaria species, age and pregnancy status while 1285 (45%) people received ‘correct and timely (within 24 h of fever)’ treatment. Children under five years, those with severe malaria, mixed infection and falciparum malaria were less likely to receive the correct treatment. When compared to health posts, village-based ICMVs and mobile teams performed better in providing correct treatment and mobile teams in providing ‘correct and timely’ treatment. This calls for ensuring the early presentation of people to health workers within 24 h of undifferentiated fever through health promotion initiatives. Future studies should assess adherence to medication and clinical improvement.

Emergency care with lay responders in underserved populations: a systematic review

“…Table 1 (available at: http://www.who.int/bulletin/volumes/99/7/20-270249 ) summarizes the studies that met the inclusion criteria, grouped by emergency medical condition, including cardiac arrest (four studies), 32 – 35 burns (two studies), 36 , 37 malaria (10 studies), 38 – 47 severe malnutrition (one study), 48 opioid poisoning (seven studies), 49 – 55 paediatric communicable diseases (five studies), 56 – 60 snakebites (one study), 61 trauma (three studies) 62 – 64 and various other emergencies (one study). 65 The authors’ data repository provides more details of secondary outcomes and data from multiple reports arising from the same study.…”

“…Most studies used observational or quasi-experimental designs, including 11 uncontrolled before-and-after studies, 35 – 37 , 46 , 50 , 53 , 55 , 60 – 62 , 64 five controlled before-and-after studies, 42 , 44 , 57 , 58 , 65 one prospective cohort study, 63 four retrospective cohort studies, 45 , 51 , 52 , 54 four case series, 32 – 34 , 41 three non-randomized cluster trials, 48 , 56 , 59 one interrupted time-series analysis 49 and one cross-sectional study. 47 Experimental studies included two randomized controlled trials 38 , 39 and two cluster randomized controlled trials. 40 , 43 …”

The effect and control of malaria in pregnancy and lactating women in the Asia-Pacific region

“…89 Barriers to timely initiation of antimalarial treatment now need to be overcome to reduce morbidity and mortality further. 90…”