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The investigators propose to compare home-based management of fever/malaria (HBMF) to health facility-based care using a cluster-randomized design in Tororo, a rural area of Uganda with high malaria transmission. Prior to the study, a census survey will be conducted to enumerate and map households, and to characterize the population. The target population will be divided into 16 clusters, defined as the catchment area of lower-level public health facilities. Clusters will be randomized to one of two interventions: HBMF in which community drug distributors dispense artemether-lumefantrine (AL) for presumptive treatment of febrile children, or enhanced health facility-based care, in which lab-confirmed cases of uncomplicated malaria will be treated as per government policy using AL. Community drug distributors will be provided appropriate training and adequate drug supplies, and health facilities will be supported with staff, diagnostics, and drug stocks as needed. Cross sectional surveys will be conducted in 400 randomly selected children per cluster to assess baseline malaria morbidity and all-cause mortality, and will be repeated annually. The census survey will be repeated at the end of the study. In addition, a sub-cohort of children will be recruited from 250 households in each intervention group using random probability sampling and will be closely followed for 2 years. The primary outcome will be prevalence of anemia (hemoglobin < 11.0 g/dL) in children under five, and secondary outcomes will include population-level measures of malaria morbidity and all-cause mortality, longitudinal measures of malaria morbidity, measures of safety and tolerability, and assessment of cost-effectiveness.
Allocation: Randomized, Control: Active Control, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
home based management of fever (HBMF), Enhanced health facility-based care
Infectious Diseases Research Collaboration
Not yet recruiting
Uganda Malaria Surveillance Project
Published on BioPortfolio: 2014-08-27T03:17:36-0400
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Those unable to leave home without exceptional effort and support; patients (in this condition) who are provided with or are eligible for home health services, including medical treatment and personal care. Persons are considered homebound even if they may be infrequently and briefly absent from home if these absences do not indicate an ability to receive health care in a professional's office or health care facility. (From Facts on File Dictionary of Health Care Management, 1988, p309)
A nursing specialty in which skilled nursing care is provided to patients in their homes by registered or licensed practical NURSES. Home health nursing differs from HOME NURSING in that home health nurses are licensed professionals, while home nursing involves non-professional caregivers.
Management of the organization of HEALTH FACILITIES.
Hospital-sponsored provision of health services, such as nursing, therapy, and health-related homemaker or social services, in the patient's home. (Hospital Administration Terminology, 2d ed)
A quality-of-life scale developed in the United States in 1972 as a measure of health status or dysfunction generated by a disease. It is a behaviorally based questionnaire for patients and addresses activities such as sleep and rest, mobility, recreation, home management, emotional behavior, social interaction, and the like. It measures the patient's perceived health status and is sensitive enough to detect changes or differences in health status occurring over time or between groups. (From Medical Care, vol.xix, no.8, August 1981, p.787-805)
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