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Randomized Controlled Trial
. 2012 Nov;87(5 Suppl):36-45.
doi: 10.4269/ajtmh.2012.11-0733.

Increased use of community medicine distributors and rational use of drugs in children less than five years of age in Uganda caused by integrated community case management of fever

Joan N Kalyango, Ann Lindstrand, Elizeus Rutebemberwa, Sarah Ssali, Daniel Kadobera, Charles Karamagi, Stefan Peterson, Tobias Alfven
Randomized Controlled Trial

Increased use of community medicine distributors and rational use of drugs in children less than five years of age in Uganda caused by integrated community case management of fever

Joan N Kalyango et al. Am J Trop Med Hyg. 2012 Nov.

Abstract

We compared use of community medicine distributors (CMDs) and drug use under integrated community case management and home-based management strategies in children 6-59 months of age in eastern Uganda. A cross-sectional study with 1,095 children was nested in a cluster randomized trial with integrated community case management (CMDs treating malaria and pneumonia) as the intervention and home-based management (CMDs treating only malaria) as the control. Care-seeking from CMDs was higher in intervention areas (31%) than in control areas (22%; P = 0.01). Prompt and appropriate treatment of malaria was higher in intervention areas (18%) than in control areas (12%; P = 0.03) and among CMD users (37%) than other health providers (9%). The mean number of drugs among CMD users compared with other health providers was 1.6 versus 2.4 in intervention areas and 1.4 versus 2.3 in control areas. Use of CMDs was low. However, integrated community case management of childhood illnesses increased use of CMDs and rational drug use.

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Figures

Figure 1.
Figure 1.
Algorithm for treatment of children by Community Medicines Distributors in Iganga-Mayuge health and demographic surveillance site. + Cough or difficult breathing with fast breathing (i.e. ≥ 50 breaths per minute for child aged 4-12 months; ≥ 40 breaths per minute for child aged 12--59 months). * Cough or difficult breathing with chest indrawing or noisy breathing.
Figure 2.
Figure 2.
Malaria symptoms treatment practices in intervention and control arms in Iganga-Mayuge demographic surveillance site, Uganda.
Figure 3.
Figure 3.
Malaria symptoms and treatment practices among community medicine distributor (CMD) and non-CMD users in Iganga-Mayuge demographic surveillance site, Uganda.
Figure 4.
Figure 4.
Self-reported pneumonia symptoms and treatment practices in intervention and control arms in Iganga-Mayuge demographic surveillance site, Uganda.
Figure 5.
Figure 5.
Self reported pneumonia symptoms and treatment practices among community medicine distributor (CMD) and non-CMD users in the intervention arm in Iganga-Mayuge demographic surveillance site, Uganda.
See this image and copyright information in PMC

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