Evaluating the impact of two training interventions to improve diagnosis and case-management of malaria and pneumonia in Uganda.
We present an age-structured mathematical model of malaria and pneumonia to study the effect of two capacity-building interventions: Integrated Management of Infectious Diseases (IMID) and On-site Support Services (OSS). IMID leads to a reduction in malaria prevalence by more than 2·4% across the [0,5), [5,14) and [14,50) age groups. IMID + OSS reduces it by more than 16·0% across all age groups. IMID decreases pneumonia prevalence by more than 3·0% across all age groups while IMID + OSS decreases it by more than 1·0% across all age groups. The number of malaria and pneumonia deaths is reduced by 7·8% by IMID across all age groups and IMID + OSS decreases this number by 30·5% across all age groups, which translates to saving a life of a child per month. Prevalence of malaria-pneumonia for the [0,5) age group is 0·52% at baseline, and IMID and IMID + OSS reduce it by 6·6% and 23·6%, respectively. There is no change in incidence of malaria or pneumonia disease episodes. The results also indicate that triaging of children contributes more than 50% to the effect of the interventions in reduction of deaths and a range of 14-91% in reduction of disease cases.
International University of East Africa (IUEA),Kampala,Uganda.
D M
DM
Ssebuliba
SACEMA, DST/NRF Centre of Excellence in Epidemiological Modelling and Analysis,Stellenbosch University,South Africa.
R
R
Ouifki
Futures Institute,Glastonbury,CT,USA.
C
C
Pretorius
Accordia Global Health Organization,Washington,DC,USA.
S M
SM
Burnett
Department of Epidemiology and Social Medicine,University of Antwerp,Antwerp,Belgium.
M K
MK
Mbonye
Department of Epidemiology and Social Medicine,University of Antwerp,Antwerp,Belgium.
S
S
Naikoba
Accordia Global Health Organization,Washington,DC,USA.
K
K
Willis
Departments of Global Health and Health Services,University of Washington,Seattle,WA,USA.
M R
MR
Weaver
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D004501:Education, Medical / Q000379:methods*; D005260:Female; D006302:Health Services Research; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D016019:Survival Analysis; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
Intervention; malaria; mathematical model; pneumonia; training
BMJ. 2005 Apr 30;330(7498):995
15797893
J Health Econ. 2010 May;29(3):445-56
20381182
Eur Respir J. 2007 Sep;30(3):517-24
17537775
Bull World Health Organ. 2006 Apr;84(4):314-9
16628305
Acta Trop. 2012 Mar;121(3):184-95
21420377
Am J Trop Med Hyg. 2008 Dec;79(6):826-33
19052287
Trop Med Int Health. 2006 Aug;11(8):1147-56
16903878
Malar J. 2004 Jun 04;3:13
15180900
Acta Trop. 2004 Apr;90(2):211-4
15177148
J Infect Dis. 1980 Dec;142(6):923-33
7462701
Bull World Health Organ. 2008 May;86(5):332-8
18545734
PLoS One. 2014 Aug 18;9(8):e103017
25133799
Math Biosci. 2004 May;189(1):1-19
15051411
PLoS One. 2011 Feb 24;6(2):e16940
21383984
QJM. 2004 Sep;97(9):591-7
15317928
PLoS One. 2014 Jan 08;9(1):e84945
24416316
J Trop Pediatr. 2009 Dec;55(6):379-87
19401405
Trop Med Int Health. 2009 Sep;14(9):1011-9
19552643
BMJ. 2004 Nov 20;329(7476):1212
15542534
PLoS One. 2012;7(9):e41458
23028427
Int J Infect Dis. 2012 Oct;16(10):e708-13
22906682
Trans R Soc Trop Med Hyg. 1999 May-Jun;93(3):283-6
10492760
Am J Trop Med Hyg. 2007 Dec;77(6 Suppl):6-13
18165469
Int J Infect Dis. 2006 Nov;10(6):458-64
16997591
Int J Antimicrob Agents. 2001 May;17(5):395-400
11337227
Malar J. 2007 Jan 17;6:3
17233881