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BACKGROUND Health workers' malaria case-management practices often differ from national guidelines. We assessed whether text-message reminders sent to health workers' mobile phones could improve and maintain their adherence to treatment guidelines for outpatient paediatric malaria in Kenya. METHODS From March 6, 2009, to May 31, 2010, we did a(More)
BACKGROUND Zambia was the first African country to change national antimalarial treatment policy to artemisinin-based combination therapy--artemether-lumefantrine. An evaluation during the early implementation phase revealed low readiness of health facilities and health workers to deliver artemether-lumefantrine, and worryingly suboptimal treatment(More)
OBJECTIVE To describe the quality of outpatient paediatric malaria case-management approximately 4-6 months after artemether-lumefantrine (AL) replaced sulfadoxine-pyrimethamine (SP) as the nationally recommended first-line therapy in Kenya. METHODS Cross-sectional survey at all government facilities in four Kenyan districts. Main outcome measures were(More)
OBJECTIVE To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. DESIGN Prospective, cluster randomised and controlled effectiveness study. SETTING Lufwanyama, an agrarian, poorly developed(More)
BACKGROUND Past studies in India included only symptomatic pregnant women and thus may have overestimated the proportion of women with malaria. Given the large population at risk, a cross sectional study was conducted in order to better define the burden of malaria in pregnancy in Jharkhand, a malaria-endemic state in central-east India. METHODS(More)
BACKGROUND Vitamin A and zinc are crucial for normal immune function, and may play a synergistic role for reducing the risk of infection including malaria caused by Plasmodium falciparum. METHODS A randomized, double-blind, placebo-controlled trial of a single dose of 200 000 IU of vitamin A with daily zinc supplementation was done in children of(More)
D iarrheal disease remains a leading cause of mortality and morbidity of children in Sub-Saharan Africa, a region where unique geographic, economic, political, sociocultural, and personal factors interact to create distinctive continuing challenges to its prevention and control. Whereas childhood mortality rates from diarrhea are expected to decrease by 30(More)
BACKGROUND Pneumonia and malaria, two of the leading causes of morbidity and mortality among children under five in Zambia, often have overlapping clinical manifestations. Zambia is piloting the use of artemether-lumefantrine (AL) by community health workers (CHWs) to treat uncomplicated malaria. Valid concerns about potential overuse of AL could be(More)
OBJECTIVE The recent change of treatment policy for uncomplicated malaria from sulfadoxine-pyrime-thamine to artemether-lumefantrine (AL) in Kenya was accompanied by revised malaria diagnosis recommendations promoting presumptive antimalarial treatment in young children and parasitological diagnosis in patients 5 years and older. We evaluated the impact of(More)