Evaluation of Integrated Community Case Management in Eight Districts of Central Uganda.

Evidence is limited on whether Integrated Community Case Management (iCCM) improves treatment coverage of the top causes of childhood mortality (acute respiratory illnesses (ARI), diarrhoea and malaria). The coverage impact of iCCM in Central Uganda was evaluated.Between July 2010 and December 2012...

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Main Authors: Denis Mubiru, Robert Byabasheija, John Baptist Bwanika, Joslyn Edelstein Meier, Godfrey Magumba, Flavia Mpanga Kaggwa, Jackson Ojera Abusu, Alex Chono Opio, Charles Clarke Lodda, Jaanki Patel, Theresa Diaz
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4534192?pdf=render
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spelling doaj-af522000cbeb4667bb85a426ab8ea7412020-11-25T00:25:35ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01108e013476710.1371/journal.pone.0134767Evaluation of Integrated Community Case Management in Eight Districts of Central Uganda.Denis MubiruRobert ByabasheijaJohn Baptist BwanikaJoslyn Edelstein MeierGodfrey MagumbaFlavia Mpanga KaggwaJackson Ojera AbusuAlex Chono OpioCharles Clarke LoddaJaanki PatelTheresa DiazEvidence is limited on whether Integrated Community Case Management (iCCM) improves treatment coverage of the top causes of childhood mortality (acute respiratory illnesses (ARI), diarrhoea and malaria). The coverage impact of iCCM in Central Uganda was evaluated.Between July 2010 and December 2012 a pre-post quasi-experimental study in eight districts with iCCM was conducted; 3 districts without iCCM served as controls. A two-stage household cluster survey at baseline (n = 1036 and 1042) and end line (n = 3890 and 3844) was done in the intervention and comparison groups respectively. Changes in treatment coverage and timeliness were assessed using difference in differences analysis (DID). Mortality impact was modelled using the Lives Saved Tool.5,586 Village Health Team members delivered 1,907,746 treatments to children under age five. Use of oral rehydration solution (ORS) and zinc treatment of diarrhoea increased in the intervention area, while there was a decrease in the comparison area (DID = 22.9, p = 0.001). Due to national stock-outs of amoxicillin, there was a decrease in antibiotic treatment for ARI in both areas; however, the decrease was significantly greater in the comparison area (DID = 5.18; p<0.001). There was a greater increase in Artemisinin Combination Therapy treatment for fever in the intervention areas than in the comparison area but this was not significant (DID = 1.57, p = 0.105). In the intervention area, timeliness of treatments for fever and ARI increased significantly higher in the intervention area than in the comparison area (DID = 2.12, p = 0.029 and 7.95, p<0.001, respectively). An estimated 106 lives were saved in the intervention area while 611 lives were lost in the comparison area.iCCM significantly increased treatment coverage for diarrhoea and fever, mitigated the effect of national stock outs of amoxicillin on ARI treatment, improved timeliness of treatments for fever and ARI and saved lives.http://europepmc.org/articles/PMC4534192?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Denis Mubiru
Robert Byabasheija
John Baptist Bwanika
Joslyn Edelstein Meier
Godfrey Magumba
Flavia Mpanga Kaggwa
Jackson Ojera Abusu
Alex Chono Opio
Charles Clarke Lodda
Jaanki Patel
Theresa Diaz
spellingShingle Denis Mubiru
Robert Byabasheija
John Baptist Bwanika
Joslyn Edelstein Meier
Godfrey Magumba
Flavia Mpanga Kaggwa
Jackson Ojera Abusu
Alex Chono Opio
Charles Clarke Lodda
Jaanki Patel
Theresa Diaz
Evaluation of Integrated Community Case Management in Eight Districts of Central Uganda.
PLoS ONE
author_facet Denis Mubiru
Robert Byabasheija
John Baptist Bwanika
Joslyn Edelstein Meier
Godfrey Magumba
Flavia Mpanga Kaggwa
Jackson Ojera Abusu
Alex Chono Opio
Charles Clarke Lodda
Jaanki Patel
Theresa Diaz
author_sort Denis Mubiru
title Evaluation of Integrated Community Case Management in Eight Districts of Central Uganda.
title_short Evaluation of Integrated Community Case Management in Eight Districts of Central Uganda.
title_full Evaluation of Integrated Community Case Management in Eight Districts of Central Uganda.
title_fullStr Evaluation of Integrated Community Case Management in Eight Districts of Central Uganda.
title_full_unstemmed Evaluation of Integrated Community Case Management in Eight Districts of Central Uganda.
title_sort evaluation of integrated community case management in eight districts of central uganda.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2015-01-01
description Evidence is limited on whether Integrated Community Case Management (iCCM) improves treatment coverage of the top causes of childhood mortality (acute respiratory illnesses (ARI), diarrhoea and malaria). The coverage impact of iCCM in Central Uganda was evaluated.Between July 2010 and December 2012 a pre-post quasi-experimental study in eight districts with iCCM was conducted; 3 districts without iCCM served as controls. A two-stage household cluster survey at baseline (n = 1036 and 1042) and end line (n = 3890 and 3844) was done in the intervention and comparison groups respectively. Changes in treatment coverage and timeliness were assessed using difference in differences analysis (DID). Mortality impact was modelled using the Lives Saved Tool.5,586 Village Health Team members delivered 1,907,746 treatments to children under age five. Use of oral rehydration solution (ORS) and zinc treatment of diarrhoea increased in the intervention area, while there was a decrease in the comparison area (DID = 22.9, p = 0.001). Due to national stock-outs of amoxicillin, there was a decrease in antibiotic treatment for ARI in both areas; however, the decrease was significantly greater in the comparison area (DID = 5.18; p<0.001). There was a greater increase in Artemisinin Combination Therapy treatment for fever in the intervention areas than in the comparison area but this was not significant (DID = 1.57, p = 0.105). In the intervention area, timeliness of treatments for fever and ARI increased significantly higher in the intervention area than in the comparison area (DID = 2.12, p = 0.029 and 7.95, p<0.001, respectively). An estimated 106 lives were saved in the intervention area while 611 lives were lost in the comparison area.iCCM significantly increased treatment coverage for diarrhoea and fever, mitigated the effect of national stock outs of amoxicillin on ARI treatment, improved timeliness of treatments for fever and ARI and saved lives.
url http://europepmc.org/articles/PMC4534192?pdf=render
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