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• W3197659858 abstract "Abstract BackgroundCommunity case management of malaria (CCMm) is an equity-focused strategy that complements and extends the reach of health services by providing timely and effective management of malaria to populations with limited access to facility-based healthcare. In Kenya, CCMm involves the use of malaria rapid diagnostic tests (mRDT) and treatment of confirmed uncomplicated malaria cases with artemether lumefantrine (AL) by community health volunteers (CHVs). The test positivity rate (TPR) from CCMm reports collected by the Ministry of Health in 2018 was twofold compared to facility-based reports for the same period. This necessitated the need to evaluate the performance of CHVs in conducting malaria RDTs.MethodThe study was conducted in four counties within the malaria lake endemic zone in Kenya with a malaria prevalence in 2018 of 27%; the national prevalence of malaria was 8%. Multi-stage cluster sampling and random selection were used. Results from 200 malaria RDTs performed by CHVs were compared with test results obtained by experienced medical laboratory technicians (MLT) performing the same test under the same conditions. Blood slides prepared by the MLTs were examined microscopically later as a backup check of the results. A kappa score was calculated to assess level of agreement. Sensitivity, specificity, positive and negative predictive values were calculated to determine diagnostic accuracy.ResultsThe median age of CHVs was 46 (IQR: 38, 52) with a range [26, 73] years. Females were 72% of the CHVs. Test positivity rates for MLTs was 42% and for CHVs was 41%. The kappa score was 0.89 indicating an almost perfect agreement in mRDT results between CHVs and MLTs. The overall sensitivity and specificity between the CHVs and MLTs were 95.0% (95% CI: (87.7, 98.6) and 94.0% (95% CI; 88.0, 97.5) respectively.ConclusionEngaging CHVs to diagnose malaria cases under CCMm yielded results which compared well with results of qualified experienced laboratory personnel. CHVs can reliably continue to offer malaria diagnosis in the community setting." @default.
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• W3197659858 date "2021-08-30" @default.
• W3197659858 modified "2023-09-27" @default.
• W3197659858 title "Implementation of community case management of malaria in malaria endemic counties of western Kenya: are community health volunteers up to the task in diagnosing malaria?" @default.
• W3197659858 doi "https://doi.org/10.21203/rs.3.rs-845559/v1" @default.
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