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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)
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)
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 evaluate treatment practices for uncomplicated malaria after the policy change from chloroquine to sulfadoxine-pyrimethamine and to artemether-lumefantrine in Zambia. DESIGN Cross sectional survey. SETTING Outpatient departments of all government and mission facilities in four districts in Zambia. PARTICIPANTS 944 children with(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)
We describe a patient who developed daptomycin-resistant, methicillin-resistant Staphylococcus aureus (MRSA) during an episode of presumed septic thrombophlebitis of the portal vein. Although daptomycin is an alternative agent for treatment of drug-resistant gram-positive bacterial infections, development of resistance during prolonged use may occur with(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)