8 research outputs found
Reactive community-based self-administered treatment against residual malaria transmission: study protocol for a randomized controlled trial
Background: Systematic treatment of all individuals living in the same compound of a clinical malaria case may
clear asymptomatic infections and possibly reduce malaria transmission, where this is focal. High and sustained
coverage is extremely important and requires active community engagement. This study explores a communitybased
approach to treating malaria case contacts.
Methods/design: This is a cluster-randomized trial to determine whether, in low-transmission areas, treating
individuals living in the same compound of a clinical malaria case with dihydroartemisinin-piperaquine can reduce
parasite carriage and thus residual malaria transmission. Treatment will be administered through the local health
system with the approach of encouraging community participation designed and monitored through formative
research. The trial goal is to show that this approach can reduce in intervention villages the prevalence of
Plasmodium falciparum infection toward the end of the malaria transmission season.
Discussion: Adherence and cooperation of the local communities are critical for the success of mass treatment
campaigns aimed at reducing malaria transmission. By exploring community perceptions of the changing trends in
malaria burden, existing health systems, and reaction to self-administered treatment, this study will develop and
adapt a model for community engagement toward malaria elimination that is cost-effective and fits within the
existing health system.
Trial registration: Clinical trials.gov, NCT02878200. Registered on 25 August 2016
Predictors of functional outcome following femoral neck fractures treated with an arthroplasty: limitations of the Harris hip score
Introduction To study the association between potential prognostic factors and functional outcome at 1 and 5 year follow-up in patients with femoral neck fractures treated with an arthroplasty. To analyze the reliability of the Harris hip score (HHS). Materials and methods A multicenter analysis which included 252 patients who sustained a femoral neck fracture treated with an arthroplasty. Functional outcome after surgery was assessed using a modified HHS and was evaluated after 1 (HHS1) and 5 (HHS5) years. Several prognostic factors were analyzed and reliability of the HHS was assessed. Results After 1 year the presence of co-morbidities was a significant (p = 0.002) predictor for a poor functional outcome (mean HHS1 71.8 with co-morbidities, and 80.6 without co-morbidities). After 5 years none of the potential prognostic factors had significant influence on functional outcome. Internal consistency testing of the HHS showed that when pain and function of the HHS were analyzed together, the internal consistency was poor (HHS1 0.38 and HHS5 0.20). The internal consistency of the HHS solely in function (without pain) improved to 0.68 (HHS1) and 0.46 (HHS5). Analyzing the functional aspect exclusively, age and the existence of co-morbidities could be defined as predictors for functional outcome of femoral neck fractures after 1 and 5 years. Conclusion After using the HHS in a modification, age and the existence of pre-operative co-morbidities appeared to be predictors of the functional outcome after 1 and 5 years. The HHS, omitting pain, is a more reliable score to estimate the functional outcome, than HHS analyzing pain and function in one scoring syste
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