Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study
Abstract Health system constraints hamper treatment of children with severe acute malnutrition (SAM) in Tanzania. This non-inferiority quasi-experimental study in Bariadi (intervention) and Maswa (control) districts assessed the effectiveness, coverage, and cost-effectiveness of SAM treatment by com...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-01-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-81811-6 |
| _version_ | 1818749388402458624 |
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| author | Calistus Wilunda Fortihappiness Gabinus Mumba Giovanni Putoto Gloria Maya Elias Musa Vincenza Lorusso Chacha Magige Germana Leyna Fabio Manenti Donata Dalla Riva Bupe Abel Ntoga Giulia Segafredo |
| author_facet | Calistus Wilunda Fortihappiness Gabinus Mumba Giovanni Putoto Gloria Maya Elias Musa Vincenza Lorusso Chacha Magige Germana Leyna Fabio Manenti Donata Dalla Riva Bupe Abel Ntoga Giulia Segafredo |
| author_sort | Calistus Wilunda |
| collection | DOAJ |
| description | Abstract Health system constraints hamper treatment of children with severe acute malnutrition (SAM) in Tanzania. This non-inferiority quasi-experimental study in Bariadi (intervention) and Maswa (control) districts assessed the effectiveness, coverage, and cost-effectiveness of SAM treatment by community health workers (CHWs) compared with outpatient therapeutic care (OTC). We included 154 and 210 children aged 6–59 months with SAM [mid-upper arm circumference (MUAC) < 11.5 cm] without medical complications in the control and intervention districts, respectively. The primary treatment outcome was cure (MUAC ≥ 12.5 cm). We performed costing analysis from the provider’s perspective. The probability of cure was higher in the intervention group (90.5%) than in the control group (75.3%); risk ratio (RR) 1.17; 95% CI 1.05, 1.31 and risk difference (RD) 0.13; 95% CI 0.04, 0.23. SAM treatment coverage was higher in the intervention area (80.9%) than in the control area (41.7%). The cost per child treated was US$146.50 in the intervention group and US$161.62 in the control group and that per child cured was US$161.77 and US$215.49 in the intervention and control groups, respectively. The additional costs per an additional child treated and cured were US$134.40 and US$130.92, respectively. Compared with OTC, treatment of children with uncomplicated SAM by CHWs was effective, increased treatment coverage and was cost-effective. |
| first_indexed | 2024-12-18T04:02:59Z |
| format | Article |
| id | doaj.art-9673a539c74b41b3bfd405f4cce70893 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-18T04:02:59Z |
| publishDate | 2021-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-9673a539c74b41b3bfd405f4cce708932022-12-21T21:21:38ZengNature PortfolioScientific Reports2045-23222021-01-011111910.1038/s41598-021-81811-6Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot studyCalistus Wilunda0Fortihappiness Gabinus Mumba1Giovanni Putoto2Gloria Maya3Elias Musa4Vincenza Lorusso5Chacha Magige6Germana Leyna7Fabio Manenti8Donata Dalla Riva9Bupe Abel Ntoga10Giulia Segafredo11Maternal and Child Wellbeing Unit, African Population and Health Research Center, APHRC CampusDoctors with Africa CUAMMDoctors with Africa CUAMMDoctors with Africa CUAMMDoctors with Africa CUAMMDoctors with Africa CUAMMSimiyu Regional Medical Officer’s OfficeTanzania Food and Nutrition CentreDoctors with Africa CUAMMDoctors with Africa CUAMMTanzania Food and Nutrition CentreDoctors with Africa CUAMMAbstract Health system constraints hamper treatment of children with severe acute malnutrition (SAM) in Tanzania. This non-inferiority quasi-experimental study in Bariadi (intervention) and Maswa (control) districts assessed the effectiveness, coverage, and cost-effectiveness of SAM treatment by community health workers (CHWs) compared with outpatient therapeutic care (OTC). We included 154 and 210 children aged 6–59 months with SAM [mid-upper arm circumference (MUAC) < 11.5 cm] without medical complications in the control and intervention districts, respectively. The primary treatment outcome was cure (MUAC ≥ 12.5 cm). We performed costing analysis from the provider’s perspective. The probability of cure was higher in the intervention group (90.5%) than in the control group (75.3%); risk ratio (RR) 1.17; 95% CI 1.05, 1.31 and risk difference (RD) 0.13; 95% CI 0.04, 0.23. SAM treatment coverage was higher in the intervention area (80.9%) than in the control area (41.7%). The cost per child treated was US$146.50 in the intervention group and US$161.62 in the control group and that per child cured was US$161.77 and US$215.49 in the intervention and control groups, respectively. The additional costs per an additional child treated and cured were US$134.40 and US$130.92, respectively. Compared with OTC, treatment of children with uncomplicated SAM by CHWs was effective, increased treatment coverage and was cost-effective.https://doi.org/10.1038/s41598-021-81811-6 |
| spellingShingle | Calistus Wilunda Fortihappiness Gabinus Mumba Giovanni Putoto Gloria Maya Elias Musa Vincenza Lorusso Chacha Magige Germana Leyna Fabio Manenti Donata Dalla Riva Bupe Abel Ntoga Giulia Segafredo Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study Scientific Reports |
| title | Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study |
| title_full | Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study |
| title_fullStr | Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study |
| title_full_unstemmed | Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study |
| title_short | Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study |
| title_sort | effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in simiyu region tanzania a quasi experimental pilot study |
| url | https://doi.org/10.1038/s41598-021-81811-6 |
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