[afro-nets] AFRO-NETS is about malaria (4)

General afro-nets
1

AFRO-NETS is about malaria (4)
------------------------------

Even if AFRO-NETS is not just about malaria, I have a question
concerning malaria control, in a sense.

In an ongoing research study on the use of bednets among preg-
nant women in Kinshasa, Democratic Republic of Congo, our re-
search team provides care for those participants who -- despite
receiving free prophylaxis and insecticide impregnated bednets
at enrollment -- end up with clinical malaria anyway. It is part
of the study protocol that we provide drugs and possible hospi-
talization for those women.

The problem is that when our researchers read the patient re-
ports (completed by nurses at local health clinics) it is obvi-
ous that only a small percentage of those women really have
clinical malaria. They are often misdiagnosed. Since they do not
have malaria, their medical care is not covered by our research
protocol -- though we assured their care anyway.

So here is my question: does anyone know of current initiatives
in Sub-Saharan Africa, particularly Francophone Africa, dedi-
cated to improvement of the case-management of malaria?

Stuart Rennie
Research Assistant Professor in Bioethics
University of North Carolina - Chapel Hill 27599-7450
Tel: +1-919-966-3585
Fax: +1-919-966-6761
mailto:stuart_rennie@DENTISTRY.UNC.EDU
Website: http://bioethics.unc.edu
Blog: http://globalbioethics.blogspot.com

2

RFI: Case-Management of Malaria (2)
-----------------------------------

Dear Stuart,

1) Integrated Management of Childhood Illness (IMCI) is often
the vehicle used to strengthen case management of malaria. Some
information can be found here:
http://www.ijppediatricsindia.org/article.asp?issn=0019-5456;year=2002;volume=69;issue=1;spage=41;epage=8;aulast=Patwari;type=0
[copy complete URL into browser]

2) In French there is the very helpful "Diagnostic et prise en
charge du paludisme grave à falciparum, Guide du stagiaire",
found at:
http://whqlibdoc.who.int/hq/2002/WHO_CDS_CPE_SMT_2000.4_Rev.1_PartieI_fre.pdf

3) Dr. Sandy Gove from the WHO has done quite a lot of work on
developing simplified guidelines for use in developing coun-
tries. See "Development and technical basis of simplified guide-
lines for emergency triage assessment and treatment in develop-
ing countries", Arch Dis Child 1999;81:473-477 ( December ),
Sandy Govea, Giorgio Tamburlinib, Elizabeth Molyneuxc, Patricia
Whiteselld, Harry Campbelle, for the WHO Integrated Management
of Childhood Illness (IMCI) Referral Care Project

4) Beyond that, the WHO malaria team has much useful information
directly related to various aspects of case mangemnt, found
here:
http://www.who.int/malaria/diagnosisandtreatment.html

WHO's page on home management talks about recognising malaria
symptoms correctly:
http://www.who.int/malaria/homemanagement.html

There is also a docuement specifically for training nurses, that
can be downloaded here:
Africa Since Independence : A Comparative History, by Paul Nu-
gent
http://w3.whosea.org/LinkFiles/Malaria_Module-Learners.pdf

5) JHPIEGO produces a "Malaria During Pregnancy Resource Pack-
age: Tools to Facilitate Policy Change and Implementation".
This resource package contains a variety of tools to help public
health professionals and health managers, and covers how to help
nurses and community health workers provide effective treatment
for pregnant women with malaria. It is available for free
download in French, and print copies can be ordered for free.
Plus JHIEPGO can be contacted directly to ask about specific as-
pects of strengthening case management, they have quite a bit of
experience.
http://www.jhpiego.org/scripts/pubs/category_detail.asp?category_id=24

6) The Southern Africa Malaria Control web site has a useful ta-
ble on malaria guidelines for community level. Scroll down about
2/3 rd's of way down page. Unfortunately, only in English.
http://www.malaria.org.zw/drugs.html

Hope this is of help!

A Happy, Peaceful and Joyous Holidays to all AFRO-NETTERS!

Cheers,
Tom O'Connell
Consultant, Planning and Implementing Health Policies
London, UK
mailto:tsoconnell2@yahoo.com