Evidence map›Paper›PMID 30567567›Full record

Trial reportBMC health services research2018

Introducing post-discharge malaria chemoprevention (PMC) for management of severe anemia in Malawian children: a qualitative study of community health workers' perceptions and motivation.

Thandile Nkosi-Gondwe, Bjarne Robberstad, Björn Blomberg, Kamija S Phiri, Siri Lange

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02721420 (Malaria Chemoprevention With Monthly Treatment With Dihydroartemisinin-Piperaquine for the Post-discharge Management of Severe Anaemia in Children Less Than 5 Years in Malawi), which is not on this map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02721420 phase3unknown statusnot on this map

Malaria Chemoprevention With Monthly Treatment With Dihydroartemisinin-Piperaquine for the Post-discharge Management of Severe Anaemia in Children Less Than 5 Years in Malawi

TypeinterventionalSponsorKamuzu University of Health SciencesRan2016 to 2019Enrolled375ConditionsMalaria, Severe AnemiaArmsdihydroartemisinin-piperaquine, message(SMS) reminder, Health worker reminder, short message(SMS) reminder
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 2 countries.

Thandile Nkosi-GondweCentre for International Health, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway. thandile_nkosi@yahoo.com.ORCID http://orcid.org/0000-0003-0999-1114
Bjarne RobberstadCentre for International Health, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway.
Björn BlombergDepartment of Clinical Science, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway.
Kamija S PhiriSchool of Public Health & Family Medicine, College of Medicine, University of Malawi, Private Bag 360, Blantyre, Malawi.
Siri LangeDepartment of Health Promotion and Development, University of Bergen, Postboks 7807, N-5020, Bergen, Norway.
University of Malawi · MWChr. Michelsen Institute · NOHaukeland University Hospital · NOUniversity of Bergen · NO

Funding

The Research Council of Norway,Global Health and Vaccination Program 234487
6 · The paper itself

Abstract

backgroundSevere malarial anaemia is one of the leading causes of paediatric hospital admissions in Malawi. Post-discharge malaria chemoprevention (PMC) is the intermittent administration of full treatment courses of antimalarial to children recovering from severe anaemia and findings suggest that this intervention significantly reduces readmissions and deaths in these children. Community delivery of health interventions utilizing community health workers (CHWs) has been successful in some programmes and not very positive in others. In Malawi, there is an on-going cluster randomised trial that aims to find the optimum strategy for delivery of dihydroartemesinin-piperaquine (DHP) for PMC in children with severe anaemia. Our qualitative study aimed to explore the feasibility of utilizing CHWs also known as health surveillance assistants (HSAs) to remind caregivers to administer PMC medication in the existing Malawian health system.

methodsBetween December 2016 and March 2018, 20 individual in-depth-interviews (IDIs) and 2 focus group discussions (FGDs) were conducted with 39 HSAs who had the responsibility of conducting home visits to remind caregivers of children who were prescribed PMC medication in the trial. All interviews were conducted in the local language, transcribed verbatim, and translated into English. The transcripts were uploaded to NVIVO 11 and analysed using the thematic framework analysis method.

resultsAlthough intrinsic motivation was reportedly high, adherence to the required number of home visits was very poor with only 10 HSAs reporting full adherence. Positive factors for adherence were the knowledge and perception of the effectiveness of PMC and the recognition from the community as well as health system. Poor training, lack of supervision, high workload, as well as technical and structural difficulties; were reported barriers to adherence by the HSAs.

conclusionsPost-discharge malaria chemoprevention with DHP is perceived as a positive approach to manage children recovering from severe anaemia by HSAs in Malawi. However, adherence to home visit reminders was very poor and the involvement of HSAs in a scale up of this intervention may pose a challenge in the existing Malawian health system.

trial registrationClinicalTrials.gov identifier NCT02721420 . The trial was registered on 26 March 2016.

Indexed as

Attitude of Health PersonnelAnemiaAntimalarialsArtemisininsCaregiversChemopreventionChildChild, PreschoolCommunity Health WorkersDrug CombinationsFeasibility StudiesFemaleFocus GroupsGovernment ProgramsHouse CallsHumansAntimalarialsArtemisininsartenimolDrug CombinationspiperaquinePiperazinesQuinolinesAnaemiaCommunity health workersMalariaMalawiSecondary preventionSocial perception

Identifiers

PMID30567567
PMCPMC6299958
OpenAlexW2903902121

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.