Impact of training in clinical and microscopy diagnosis of childhood malaria on antimalarial drug prescription and health outcome at primary health care level in Tanzania: A randomized controlled trial

2008

Training in Malaria Diagnosis Reduces Drug Prescriptions in Tanzania

Sample size: 3131 publication 10 minutes Evidence: moderate

Author Information

Author(s): Ngasala Billy, Mubi Marycelina, Warsame Marian, Petzold Max G, Massele Amos Y, Gustafsson Lars L, Tomson Goran, Premji Zul, Bjorkman Anders

Primary Institution: Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden

Hypothesis

Does training in clinical and microscopy diagnosis of childhood malaria affect antimalarial drug prescription and health outcomes at primary health care level?

Conclusion

Microscopy-based diagnosis of malaria at primary health care facilities reduces prescription of antimalarial drugs and improves management of non-malaria fevers, despite significant variation in microscopy accuracy.

Supporting Evidence

Antimalarial prescriptions were significantly reduced in Arm-I (61.3%) compared to Arms-II (95.3%) and III (99.5%).
In Arm-I, 99.1% of children with positive blood smear readings received antimalarial prescriptions.
Patients with negative blood smears were less likely to receive antibiotics compared to those with positive smears.

Takeaway

Training health workers to use microscopes helps them give the right medicine for malaria, which means fewer kids get unnecessary malaria drugs.

Methodology

A cluster randomized controlled trial was conducted in 16 primary health care facilities in rural Tanzania, comparing training in clinical algorithm plus microscopy versus clinical algorithm only and no training.