title: Effectiveness of trained community volunteers in improving knowledge and management of childhood malaria in a rural area of Rivers State, Nigeria.
abstract: Malaria accounts for 70% of illnesses and 30% of deaths among children under 5 years in Nigeria. This study was aimed at determining the effectiveness of trained community volunteers in delivering multiple anti-malaria interventions to achieve rapid reduction in morbidity and mortality among under 5 children.
  
  
  
  A quasi-experimental study was carried out in two rural communities in Rivers State, Nigeria among 368 mothers/caregivers. A set of 184 of the mothers/caregivers (experimental group) were trained on malaria and provided with bed nets and drugs (artemisinin-lumefantrine) to treat children under 5 years who developed fever during the period of the experiment. Another set of 184 mothers/caregivers (controls) did not receive similar training and drugs. Both groups were compared at baseline and after 6 months of the experiment on their knowledge of malaria prevention and treatment. Level of significance was set at P = 0.05.
  
  
  
  In the experimental group: Adequate knowledge about malaria increased from 115 (62.5%) to 175 (95.1%) (P < 0.0001), early commencement of treatment of fever increased from 68 (37.0%) to 131 (75.7%) (P < 0.0001), and children cured of malaria increased from 87 (47.3%) to 146 (84.4%) (P < 0.0001). Insecticide-treated bed nets use also increased from 86 (46.7%) to 161 (87.5%) (P < 0.0001). There were no significant changes in the control group.
  
  
  
  The study demonstrated the inherent potentials in using community-based volunteers in malaria prevention and control for those in rural areas with poor health service delivery. We advocate its adaptation for far-reaching reduction in childhood morbidity and mortality and rapid attainment of millennium development goals 4.
authors.affiliation: Department of Preventive and Social Medicine, College of Health Sciences, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria.
authors.forename: C I
authors.initials: CI
authors.lastname: Tobin-West
authors.forename: Nct
authors.initials: N
authors.lastname: Briggs
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins / Q000627:therapeutic use; D017028:Caregivers / Q000193:education*; D002648:Child; D002675:Child, Preschool; D004983:Ethanolamines / Q000627:therapeutic use; D005260:Female; D005449:Fluorenes / Q000627:therapeutic use; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D057148:Insecticide-Treated Bednets; D000078102:Lumefantrine; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D008297:Male; D009017:Morbidity; D009035:Mothers / Q000193:education*; D009549:Nigeria; D017063:Outcome Assessment, Health Care; D012424:Rural Population; D014838:Volunteers / Q000193:education
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D004983:Ethanolamines; D005449:Fluorenes; C031327:artemisinin; D000078102:Lumefantrine