title: Sustained protection against mortality and morbidity from malaria in rural Gambian children by chemoprophylaxis given by village health workers.
abstract: Mortality and morbidity from malaria were measured in children for a one-year period in a rural area of The Gambia 3-4 years after the introduction of a primary health care programme into some villages in the study area. Among children resident in primary health care villages who received treatment for febrile illnesses from a village health worker resident in their village there was no reduction in overall mortality or in morbidity from malaria compared with levels found in villages without a primary health care worker. However, among children aged 3-59 months who received malaria chemoprophylaxis from a village health worker in addition to treatment there was a 49% reduction in mortality and a 73% reduction in attacks of clinical malaria. The level of protection against malaria achieved by chemoprophylaxis given by village health workers 3-4 years after the chemoprophylaxis programme was started was as high as that obtained shortly after the introduction of the primary health care programme.
authors.affiliation: Medical Research Council Laboratories, Fajara, Banjul, The Gambia.
authors.forename: A
authors.initials: A
authors.lastname: Menon
authors.forename: R W
authors.initials: RW
authors.lastname: Snow
authors.forename: P
authors.initials: P
authors.lastname: Byass
authors.forename: B M
authors.initials: BM
authors.lastname: Greenwood
authors.forename: R J
authors.initials: RJ
authors.lastname: Hayes
authors.forename: A B
authors.initials: AB
authors.lastname: N'Jie
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use*; D002675:Child, Preschool; D003150:Community Health Workers; D003622:Dapsone / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005714:Gambia; D006801:Humans; D008288:Malaria / Q000150:complications / Q000401:mortality / Q000517:prevention & control*; D008297:Male; D010349:Patient Compliance; D011320:Primary Health Care; D011739:Pyrimethamine / Q000627:therapeutic use*; D012424:Rural Population
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001678:Maloprim; D003622:Dapsone; D011739:Pyrimethamine