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    Jan 17, 2021
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    Management of malaria in children with fever in rural Sierra Leone in relation to the 2014-2015 Ebola outbreak

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    Moses et al - 2017 - Management ...
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    Authors
    Moses, FL
    Tamang, D
    Denisiuk, O
    Dumbuya, U
    Hann, K
    Zachariah, R
    Issue Date
    2017-06-21
    Submitted date
    2018-05-16
    
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    Journal
    Public Health Action
    Abstract
    Setting: Sixty-eight primary health facilities, Koinadugu District, rural Sierra Leone. Objectives: Sierra Leone, a country with one of the highest burdens of malaria, was severely affected by the 2014-2015 Ebola virus disease outbreak. In under-five children, we compared trends in the completeness of malaria reports sent to the district office during the pre-Ebola, Ebola and post-Ebola periods, including the number of children with reported fever, malaria diagnostic testing performed and treatment for malaria initiated with artemisinin-based combination therapy (ACT). Design: A cross-sectional study. Results: Of 1904 expected malaria reports, 1289 (68%) were received. Completeness of reporting was 61% pre-Ebola, increased to 88% during the outbreak and dropped to 44% post-Ebola (P = 0.003). Total malaria testing (n = 105 558) exceeded the number of fever cases (n = 105 320). Pre-Ebola, 75% (n = 43 245) of all reported fever cases received malaria treatment, dropping to 34% (n = 50 453) during the Ebola outbreak. Of 36 804 confirmed malaria cases during Ebola, 17 438 (47%) were treated, significantly fewer than in the pre-Ebola period (96%, P < 0.001). Of the fever cases, 95% in both the pre- and post-Ebola periods received ACT, a rate that increased to 99% during the Ebola outbreak. Conclusion: Pre-existing gaps in malaria reporting worsened after the Ebola outbreak. Reassuringly, malaria testing matched fever cases, although only half of all confirmed cases received treatment during the outbreak, possibly explained by outbreak-related operational difficulties. These findings could be useful to guide health systems strengthening and recovery.
    Publisher
    International Union Against Tuberculosis and Lung Disease
    URI
    http://hdl.handle.net/10144/619126
    DOI
    10.5588/pha.16.0085
    PubMed ID
    28744435
    Language
    en
    ISSN
    2220-8372
    ae974a485f413a2113503eed53cd6c53
    10.5588/pha.16.0085
    Scopus Count
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    Operational Research Courses

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