title: Effectiveness of a community intervention on malaria in rural Tanzania - a randomised controlled trial.
abstract: BACKGROUND
  Malaria infections are a major public health problem in Africa and prompt treatment is one way of controlling the disease and saving lives.
  
  
  METHODS
  This cluster-randomised controlled community intervention conducted in 2003-2005 aimed at improving early malaria case management in under five children. Health workers were trained to train community-based women groups in recognizing malaria symptoms, providing first-line treatment for uncomplicated malaria and referring severe cases. Evaluation was through a pre- (2004) and a post-intervention survey (2005). Anaemia prevalence was the primary outcome.
  
  
  RESULTS
  1715 children aged 6-59 months were included in the pre-intervention survey and 2169 in the post-intervention survey. The prevalence of anaemia decreased significantly from 37% [95% CI 34.7-39.3] to 0.5% [95% CI 0.2-0.7] after the intervention (p<0.001); slightly more in the intervention (from 43.9% to 0.8%) than in the control (30.8% to 0.17%) group (p=0.038). Fever and reported fever decreased significantly and the mean body weight of the children increased significantly over the study period in both control and intervention groups.
  
  
  CONCLUSIONS
  The decrease in anaemia was significantly associated with the intervention, whereas the fever and body weight trends might be explained by other malaria control activities or seasonal/climate effects in the area. The community intervention was shown to be feasible in the study context.
authors.affiliation: Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Sweden. jaran.eriksen@ki.se
authors.forename: J
authors.initials: J
authors.lastname: Eriksen
authors.forename: P
authors.initials: P
authors.lastname: Mujinja
authors.forename: M
authors.initials: M
authors.lastname: Warsame
authors.forename: S
authors.initials: S
authors.lastname: Nsimba
authors.forename: B
authors.initials: B
authors.lastname: Kouyaté
authors.forename: L L
authors.initials: LL
authors.lastname: Gustafsson
authors.forename: A
authors.initials: A
authors.lastname: Jahn
authors.forename: O
authors.initials: O
authors.lastname: Müller
authors.forename: R
authors.initials: R
authors.lastname: Sauerborn
authors.forename: G
authors.initials: G
authors.lastname: Tomson
mesh_terms: D000328:Adult; D000740:Anemia / Q000188:drug therapy / Q000453:epidemiology; D000962:Antimalarials / Q000627:therapeutic use*; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D009035:Mothers / Q000193:education*; D015995:Prevalence; D015397:Program Evaluation; D012111:Residence Characteristics; D012424:Rural Population; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology
chemical_list: D000962:Antimalarials