Acceptability and Cost Effectiveness of Home Based Management of Fever: Different Strategies
Status:
Terminated
Trial end date:
2005-11-01
Target enrollment:
Participant gender:
Summary
Malaria remains a major cause of morbidity and mortality particularly among children < 5
years in Uganda. Due to inaccessibility many children die before they reach the health
facility. The Home Based Management of Fever (HBMF) strategy was adopted in Uganda as a mean
to improve access to early and appropriate treatment of fever at community level. Pre-packed
chloroquine with sulphadoxine-pyrimethamine (HOMAPAK) is provided through Community Drug
Distributors(CDDs). Initial evaluation showed underutilization of the CDDs (15%). This cast
doubt on community acceptability, accessibility as well as its feasibility and cost
effectiveness. This 3-year project intends to compare community acceptability and cost
effectiveness of two HOMAPAK distribution methods. The current CDD-based HOMAPAK distribution
versus home-based HOMAPAK distribution. The study hypothesis is that "home-based HOMAPAK
distribution is more acceptable to the community and more cost effective than the CDD based
HOMAPAK A non randomised community study will be conducted in two sub-counties of Mukono
district. In the control arm, HOMAPAKs will be distributed through the CDDs while in the
intervention arm, HOMAPAKs will be directly distributed to the caretakers in the homes. The
study population are caretakers and their children < 5 years. At baseline a survey (Phase 1)
with a sample size 657 in each study area will assess the common drugs stocked at home to
treat malaria and the health seeking behaviour for malaria for children < 5 years and to
determine the prevalence of malaria parasitaemia and anaemia among children < 5 years. Phase
2 includes the intervention. The villages will be assigned to either the control or
intervention arm. Anaemia and malaria parasitaemia among children with fever will be assessed
through active case finding. The impact of either distribution system on accessibility,
acceptability, sustainability, compliance, cost effectiveness and malaria morbidity will be
assessed during the evaluation phase. Health education messages on malaria prevention and
treatment will be given to both communities. Drug misuse will be limited by distributing
HOMAPAKs according to the number of children <5years in each household. HOMAPAK will only be
replenished after the caretaker returns a used packet to the CDD.
Phase:
N/A
Details
Lead Sponsor:
DBL -Institute for Health Research and Development
Collaborators:
Institute for Epidemiology and Social Medicine, Aarhus University, Denmark World Health Organization
Treatments:
Chloroquine Fanasil, pyrimethamine drug combination Pyrimethamine Sulfadoxine