Case Management

Publication Title: 
The Cochrane Database of Systematic Reviews

BACKGROUND: Breathlessness is a common and distressing symptom in the advanced stages of malignant and non-malignant diseases. Appropriate management requires both pharmacological and non-pharmacological interventions. OBJECTIVES: The primary objective was to determine the effectiveness of non-pharmacological and non-invasive interventions to relieve breathlessness in participants suffering from the five most common conditions causing breathlessness in advanced disease.

Author(s): 
Bausewein, C.
Booth, S.
Gysels, M.
Higginson, I.
Publication Title: 
The Gerontologist

PURPOSE: This study measures the differential effects of home care client characteristics typically included in standardized needs assessment protocols, and client characteristics such as attitude or demeanor that arise from the case manager-client interpersonal dynamic during the assessment process, on care plan decisions.

Author(s): 
Corazzini-Gomez, Kirsten
Publication Title: 
Tropical medicine & international health: TM & IH

OBJECTIVE: To study the quality of malaria case management of underfives at health facilities in a rural district, 2 years after the Tanzanian malaria treatment policy change in 2001. METHODS: Consultations of 117 sick underfives by 12 health workers at 8 health facilities in Mkuranga District, Tanzania were observed using checklists for history taking, counselling and prescription. Diagnoses and treatment were recorded. Exit interviews were performed with all mothers/guardians and blood samples taken from the underfives for the detection of malaria parasites and antimalarial drugs.

Author(s): 
Eriksen, J.
Tomson, G.
Mujinja, P.
Warsame, M. Y.
Jahn, A.
Gustafsson, L. L.
Publication Title: 
Malaria Journal

BACKGROUND: Zambia was the first African country to change national antimalarial treatment policy to artemisinin-based combination therapy--artemether-lumefantrine. An evaluation during the early implementation phase revealed low readiness of health facilities and health workers to deliver artemether-lumefantrine, and worryingly suboptimal treatment practices. Improvements in the case-management of uncomplicated malaria two years after the initial evaluation and three years after the change of policy in Zambia are reported.

Author(s): 
Zurovac, Dejan
Ndhlovu, Mickey
Sipilanyambe, Nawa
Chanda, Pascalina
Hamer, Davidson H.
Simon, Jon L.
Snow, Robert W.
Publication Title: 
Malaria Journal

BACKGROUND: Kenya recently changed its antimalarial drug policy to a specific artemisinin-based combination therapy (ACT), artemether-lumefantrine (AL). New national guidelines on the diagnosis, treatment and prevention were developed and disseminated to health workers together with in-service training. METHODS: Between January and March 2007, 36 in-depth interviews were conducted in five rural districts with health workers who attended in-service training and were non-adherent to the new guidelines.

Author(s): 
Wasunna, Beatrice
Zurovac, Dejan
Goodman, Catherine A.
Snow, Robert W.
Publication Title: 
BMC public health

BACKGROUND: Throughout Africa, the private retail sector has been recognised as an important source of antimalarial treatment, complementing formal health services. However, the quality of advice and treatment at private outlets is a widespread concern, especially with the introduction of artemisinin-based combination therapies (ACTs). As a result, ACTs are often deployed exclusively through public health facilities, potentially leading to poorer access among parts of the population. This research aimed at assessing the performance of the retail sector in rural Tanzania.

Author(s): 
Hetzel, Manuel W.
Dillip, Angel
Lengeler, Christian
Obrist, Brigit
Msechu, June J.
Makemba, Ahmed M.
Mshana, Christopher
Schulze, Alexander
Mshinda, Hassan
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

Data on malaria rapid diagnostic test (RDT) performance under routine program conditions are limited. We assessed the attributes of RDTs performed by study and health facility (HF) staffs as part of routine malaria case management of patients > or = 5 years of age in Kenya. Expert microscopy was used as our gold standard. A total of 1,827 patients were enrolled; 191 (11.6%) were parasitemic by expert microscopy. Sensitivity and specificity of RDTs performed by study staff were 86.6% (95% confidence interval [CI]: 79.8-93.5%) and 95.4% (95% CI: 93.9-96.9%), respectively.

Author(s): 
de Oliveira, Alexandre Macedo
Skarbinski, Jacek
Ouma, Peter O.
Kariuki, Simon
Barnwell, John W.
Otieno, Kephas
Onyona, Phillip
Causer, Louise M.
Laserson, Kayla F.
Akhwale, Willis S.
Slutsker, Laurence
Hamel, Mary
Publication Title: 
Malaria Journal

BACKGROUND: Angola's malaria case-management policy recommends treatment with artemether-lumefantrine (AL). In 2006, AL implementation began in Huambo Province, which involved training health workers (HWs), supervision, delivering AL to health facilities, and improving malaria testing with microscopy and rapid diagnostic tests (RDTs). Implementation was complicated by a policy that was sometimes ambiguous.

Author(s): 
Rowe, Alexander K.
de León, Gabriel F. Ponce
Mihigo, Jules
Santelli, Ana Carolina F. S.
Miller, Nathan P.
Van-Dúnem, Pedro
Publication Title: 
Malaria Journal

BACKGROUND: Early and accurate diagnosis of malaria followed by prompt treatment reduces the risk of severe disease in malaria endemic regions. Presumptive treatment of malaria is widely practised where microscopy or rapid diagnostic tests (RDTs) are not readily available.

Author(s): 
Kyabayinze, Daniel J.
Asiimwe, Caroline
Nakanjako, Damalie
Nabakooza, Jane
Counihan, Helen
Tibenderana, James K.
Publication Title: 
Malaria Journal

BACKGROUND: Many malarious countries plan to introduce artemisinin combination therapy (ACT) at community level using community health workers (CHWs) for treatment of uncomplicated malaria. Use of ACT with reliance on presumptive diagnosis may lead to excessive use, increased costs and rise of drug resistance. Use of rapid diagnostic tests (RDTs) could address these challenges but only if the communities will accept their use by CHWs. This study assessed community acceptability of the use of RDTs by Ugandan CHWs, locally referred to as community medicine distributors (CMDs).

Author(s): 
Mukanga, David
Tibenderana, James K.
Kiguli, Juliet
Pariyo, George W.
Waiswa, Peter
Bajunirwe, Francis
Mutamba, Brian
Counihan, Helen
Ojiambo, Godfrey
Källander, Karin

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