Acceptability of pre-referral rectal artesunate for severe malaria in children under 5 years by health workers and caregivers in the Democratic Republic of the Congo, Nigeria and Uganda
Abstract Background For children below 6 years with suspected severe malaria attending a health care provider unable to provide parenteral malaria treatment, pre-referral rectal artesunate (RAS) is recommended by the World Health Organization to prevent death and disability. A number of African coun...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-11-01
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| Series: | Malaria Journal |
| Online Access: | https://doi.org/10.1186/s12936-022-04348-7 |
| _version_ | 1817970507298897920 |
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| author | Phyllis Awor Joseph Kimera Proscovia Athieno Gloria Tumukunde Jean Okitawutshu Antoinette Tshefu Elizabeth Omoluabi Aita Signorell Nina Brunner Jean-Claude Kalenga Babatunde Akano Kazeem Ayodeji Charles Okon Ocheche Yusuf Giulia Delvento Tristan Lee Christian Burri Christian Lengeler Manuel W. Hetzel |
| author_facet | Phyllis Awor Joseph Kimera Proscovia Athieno Gloria Tumukunde Jean Okitawutshu Antoinette Tshefu Elizabeth Omoluabi Aita Signorell Nina Brunner Jean-Claude Kalenga Babatunde Akano Kazeem Ayodeji Charles Okon Ocheche Yusuf Giulia Delvento Tristan Lee Christian Burri Christian Lengeler Manuel W. Hetzel |
| author_sort | Phyllis Awor |
| collection | DOAJ |
| description | Abstract Background For children below 6 years with suspected severe malaria attending a health care provider unable to provide parenteral malaria treatment, pre-referral rectal artesunate (RAS) is recommended by the World Health Organization to prevent death and disability. A number of African countries are in the process of rolling out quality-assured RAS for pre-referral treatment of severe malaria at community-level. The success of RAS depends, among other factors, on the acceptability of RAS in the communities where it is being rolled-out. Yet to date, there is limited literature on RAS acceptability. This study aimed to determine the acceptability of RAS by health care providers and child caregivers in communities where quality assured RAS was rolled out. This study was nested within the comprehensive multi-country observational research project Community Access to Rectal Artesunate for Malaria (CARAMAL), implemented in the Democratic Republic of the Congo (DRC), Nigeria, and Uganda between 2018 and 2020. Data from three different sources were analysed to understand RAS acceptability: interviews with health workers during three health care provider surveys (N = 341 community health workers and 467 primary health facility workers), with caregivers of children < 5 years of age during three household surveys (N = 9332 caregivers), and with caregivers of children < 5 years of age who were treated with RAS and enrolled in the CARAMAL Patient Surveillance System (N = 3645 caregivers). Results RAS acceptability was high among all interviewed stakeholders in the three countries. After the roll-out of RAS, 97–100% heath care providers in DRC, 98–100% in Nigeria and 93–100% in Uganda considered RAS as very good or good. Majority of caregivers whose children had received RAS for pre-referral management of severe malaria indicated that they would want to get the medication again, if their child had the same illness (99.8% of caregivers in DRC, 100% in Nigeria and 99.9% in Uganda). In three household surveys, 67–80% of caregivers whose children had not previously received RAS considered the medication as useful. Conclusion RAS was well accepted by health workers and child caregivers in DRC, Nigeria and Uganda. Acceptability is unlikely to be an obstacle to the large-scale roll-out of RAS in the studied settings. |
| first_indexed | 2024-04-13T20:35:02Z |
| format | Article |
| id | doaj.art-1fd531449c034808bdeb78ad1ef85f49 |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-04-13T20:35:02Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-1fd531449c034808bdeb78ad1ef85f492022-12-22T02:31:04ZengBMCMalaria Journal1475-28752022-11-012111810.1186/s12936-022-04348-7Acceptability of pre-referral rectal artesunate for severe malaria in children under 5 years by health workers and caregivers in the Democratic Republic of the Congo, Nigeria and UgandaPhyllis Awor0Joseph Kimera1Proscovia Athieno2Gloria Tumukunde3Jean Okitawutshu4Antoinette Tshefu5Elizabeth Omoluabi6Aita Signorell7Nina Brunner8Jean-Claude Kalenga9Babatunde Akano10Kazeem Ayodeji11Charles Okon12Ocheche Yusuf13Giulia Delvento14Tristan Lee15Christian Burri16Christian Lengeler17Manuel W. Hetzel18School of Public Health, Makerere University College of Health SciencesSchool of Public Health, Makerere University College of Health SciencesSchool of Public Health, Makerere University College of Health SciencesSchool of Public Health, Makerere University College of Health SciencesKinshasa School of Public Health, University of KinshasaKinshasa School of Public Health, University of KinshasaAkena AssociatesSwiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteKinshasa School of Public Health, University of KinshasaAkena AssociatesAkena AssociatesAkena AssociatesAkena AssociatesSwiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteSwiss Tropical and Public Health InstituteAbstract Background For children below 6 years with suspected severe malaria attending a health care provider unable to provide parenteral malaria treatment, pre-referral rectal artesunate (RAS) is recommended by the World Health Organization to prevent death and disability. A number of African countries are in the process of rolling out quality-assured RAS for pre-referral treatment of severe malaria at community-level. The success of RAS depends, among other factors, on the acceptability of RAS in the communities where it is being rolled-out. Yet to date, there is limited literature on RAS acceptability. This study aimed to determine the acceptability of RAS by health care providers and child caregivers in communities where quality assured RAS was rolled out. This study was nested within the comprehensive multi-country observational research project Community Access to Rectal Artesunate for Malaria (CARAMAL), implemented in the Democratic Republic of the Congo (DRC), Nigeria, and Uganda between 2018 and 2020. Data from three different sources were analysed to understand RAS acceptability: interviews with health workers during three health care provider surveys (N = 341 community health workers and 467 primary health facility workers), with caregivers of children < 5 years of age during three household surveys (N = 9332 caregivers), and with caregivers of children < 5 years of age who were treated with RAS and enrolled in the CARAMAL Patient Surveillance System (N = 3645 caregivers). Results RAS acceptability was high among all interviewed stakeholders in the three countries. After the roll-out of RAS, 97–100% heath care providers in DRC, 98–100% in Nigeria and 93–100% in Uganda considered RAS as very good or good. Majority of caregivers whose children had received RAS for pre-referral management of severe malaria indicated that they would want to get the medication again, if their child had the same illness (99.8% of caregivers in DRC, 100% in Nigeria and 99.9% in Uganda). In three household surveys, 67–80% of caregivers whose children had not previously received RAS considered the medication as useful. Conclusion RAS was well accepted by health workers and child caregivers in DRC, Nigeria and Uganda. Acceptability is unlikely to be an obstacle to the large-scale roll-out of RAS in the studied settings.https://doi.org/10.1186/s12936-022-04348-7 |
| spellingShingle | Phyllis Awor Joseph Kimera Proscovia Athieno Gloria Tumukunde Jean Okitawutshu Antoinette Tshefu Elizabeth Omoluabi Aita Signorell Nina Brunner Jean-Claude Kalenga Babatunde Akano Kazeem Ayodeji Charles Okon Ocheche Yusuf Giulia Delvento Tristan Lee Christian Burri Christian Lengeler Manuel W. Hetzel Acceptability of pre-referral rectal artesunate for severe malaria in children under 5 years by health workers and caregivers in the Democratic Republic of the Congo, Nigeria and Uganda Malaria Journal |
| title | Acceptability of pre-referral rectal artesunate for severe malaria in children under 5 years by health workers and caregivers in the Democratic Republic of the Congo, Nigeria and Uganda |
| title_full | Acceptability of pre-referral rectal artesunate for severe malaria in children under 5 years by health workers and caregivers in the Democratic Republic of the Congo, Nigeria and Uganda |
| title_fullStr | Acceptability of pre-referral rectal artesunate for severe malaria in children under 5 years by health workers and caregivers in the Democratic Republic of the Congo, Nigeria and Uganda |
| title_full_unstemmed | Acceptability of pre-referral rectal artesunate for severe malaria in children under 5 years by health workers and caregivers in the Democratic Republic of the Congo, Nigeria and Uganda |
| title_short | Acceptability of pre-referral rectal artesunate for severe malaria in children under 5 years by health workers and caregivers in the Democratic Republic of the Congo, Nigeria and Uganda |
| title_sort | acceptability of pre referral rectal artesunate for severe malaria in children under 5 years by health workers and caregivers in the democratic republic of the congo nigeria and uganda |
| url | https://doi.org/10.1186/s12936-022-04348-7 |
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