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Artemisinin based combination therapy for uncomplicated malaria management among children under five in Cameroon: a
Patrick Mbah Okwen1,2, Bedes Ngem1, Olivette Ndum Chia3
1Bali District Hospital, Northwest Region, Cameroon.
Insights
Implementing evidence-based practice for artemisinin-based combination therapy (ACT) improved malaria treatment in children under five. Despite barriers, this approach enhances patient care and resource use in Cameroon.
Area of Science:
- Global Health
- Malaria Control
- Evidence-Based Practice
Background:
- Malaria remains a significant threat to children under five, despite recent improvements.
- Artemisinin-based combination therapy (ACT) is a highly effective treatment for uncomplicated Plasmodium falciparum malaria.
- The World Health Organization recommends a "test, treat and track" strategy using diagnostics and ACTs.
Purpose of the Study:
- To promote evidence-based practice in artemisinin-based combination therapy (ACT) for managing uncomplicated malaria in children under five.
- To improve patient outcomes and resource utilization in the Bali Health District, Cameroon.
- To implement and evaluate strategies for evidence-based healthcare.
Main Methods:
- Utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES).
- Employed the Getting Research into Practice (GRiP) audit and feedback tool.
- Involved a three-phase activity approach for evidence implementation.
Main Results:
- Compliance with best practice recommendations improved by 31% overall after four months.
- Variations in compliance rates were observed across different sites.
- Nineteen barriers to implementation were identified, categorized by stakeholder (clinician, community health worker, patient, policymaker).
Conclusions:
- Evidence implementation is achievable despite identified barriers.
- Adopting evidence-based practices demonstrably improves the quality of care for malaria management.
Objective:
The aim of this evidence implementation project is to promote evidence-based practice in artemisinin-based combination therapy for managing uncomplicated malaria in children under five, thereby improving patient outcomes and resource utilization in the Bali Health District, Cameroon.
Introduction:
The burden of disease attributable to malaria has significantly improved in the last three years, however morbidity and mortality risks are still present, especially for children under five. In children with uncomplicated P. falciparum malaria, there is strong evidence to suggest that artemisinin-based combination therapy (ACT) is effective in treating malaria. The World Health Organization has strong recommendations with high-quality evidence guiding practice in the "test, treat and track" approach using microscopy, rapid diagnostics tests and ACTs.
Methods:
This evidence implementation project used the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit and feedback tool for promoting evidence-based healthcare involving three phases of activity.
Results:
We compared compliance with best practice recommendations at baseline against a follow-up compliance at four months, following implementation of strategies identified. Compliance rates improved overall by 31% (R: 20-42) for all criteria and sites, with differences noticed between sites. Nineteen barriers were identified, stratified into clinician, community health worker, patient and policy maker related barriers.
Conclusions:
Despite existing barriers to evidence implementation, getting research into practice is possible and does improve quality of care.
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