title: Impact of home-based management of malaria combined with other community-based interventions: what do we learn from Rwanda?
abstract: BACKGROUND
  This study aimed to evaluate the impact of home-based management of malaria (HBM) strategy on time to treatment and reported presumed malaria morbidity in children aged less than 5 years in Rwanda.
  
  
  METHODS
  The study was carried out in two malaria-endemic rural districts, one where HBM was applied and the other serving as control. In each district, a sample of mothers was surveyed by questionnaire before (2004) and after (2007) implementation of HBM.
  
  
  RESULTS
  After implementation, we observed: i) an increase (P < 0.001) in the number of febrile children treated within 24 hours of symptom onset in the experimental district (53.7% in 2007 vs 5% in 2004) compared with the control district (28% vs 7.7%); ii) a decrease in the reported number of febrile children in the experimental district (28.7% vs 44.9%, P < 0.01) compared with the control district (45.7% vs 56.5%, P < 0.05).
  
  
  CONCLUSIONS
  HBM contributed to decrease time to treatment and reported presumed malaria morbidity.
authors.affiliation: National University of Rwanda School of Public Health, Kigali, Rwanda.
authors.forename: Manasse
authors.initials: M
authors.lastname: Nzayirambaho
authors.forename: Jean De Dieu
authors.initials: Jde D
authors.lastname: Bizimana
authors.forename: Robert Jean
authors.initials: RJ
authors.lastname: Freund
authors.forename: Pascal
authors.initials: P
authors.lastname: Millet
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Merrien
authors.forename: Gilles
authors.initials: G
authors.lastname: Potel
authors.forename: Pierre
authors.initials: P
authors.lastname: Lombrail
mesh_terms: D000328:Adult; D002675:Child, Preschool; D003153:Community Health Services; D006701:Home Nursing; D006801:Humans; D007223:Infant; D008288:Malaria / Q000628:therapy*; D009035:Mothers; D012432:Rwanda; D011795:Surveys and Questionnaires
keywords: Children; Rwanda; fever; malaria
references.citation: Sante. 2004 Apr-Jun;14(2):101-7
references.pmid: 15454369
references.citation: Trop Med Int Health. 2005 Jan;10(1):1-2
references.pmid: 15655007
references.citation: Malar J. 2008 Aug 27;7:167
references.pmid: 18752677
references.citation: Ann Trop Paediatr. 2005 Jun;25(2):91-100
references.pmid: 15949197
references.citation: Malar J. 2007 Nov 15;6:151
references.pmid: 18005422
references.citation: Am J Trop Med Hyg. 2003 Jun;68(6):743-7
references.pmid: 12887037
references.citation: Am J Trop Med Hyg. 2004 Aug;71(2 Suppl):1-15
references.pmid: 15331814
references.citation: Malar J. 2008 Oct 03;7:201
references.pmid: 18834504
references.citation: Trans R Soc Trop Med Hyg. 2007 Apr;101(4):344-50
references.pmid: 17005222
references.citation: Trans R Soc Trop Med Hyg. 2000 May-Jun;94(3):285-8
references.pmid: 10975000
references.citation: Malar J. 2007 Oct 08;6:134
references.pmid: 17922916
references.citation: Malar J. 2009 Jan 14;8:14
references.pmid: 19144183
references.citation: Nature. 2005 Sep 8;437(7056):E3; discussion E4-5
references.pmid: 16148888
references.citation: Bull World Health Organ. 1996;74(4):423-30
references.pmid: 8823965
references.citation: World Health Organ Tech Rep Ser. 2000;892:i-v, 1-74
references.pmid: 10892307
references.citation: PLoS Med. 2007 Nov 6;4(11):e309
references.pmid: 17988171