How effective are trained role model caregivers in prompt presumptive treatment of malaria of under 5 children in Kaduna state, North western Nigeria?

Objective: Malaria is Africa's leading cause of under 5 mortality, constituting 10% of the overall disease burden. A major strategy for reducing the burden of malaria is prompt access to effective antimalarials. Community Case Management of malaria (CCMm) can be used to achieve the 80% treatment target of uncomplicated malaria within 24 hours of onset of symptoms. CCMm aims to train selected community members to recognize symptoms of malaria and give appropriate early and prompt treatment. We conducted this study to assess CCMm in trained Role Model caregivers (RMCs) of under fives in Kaduna state, Nigeria. Methods: We conducted a descriptive cross sectional survey in Kaduna state. A sample of 308 RMCs were selected by multistage sampling and interviewed using a standardized questionnaire. The questionnaire had questions on sociodemographic characteristics, malaria transmission and treatment. Results: Mean age (SD) of RMCs was 35.34 years (±8.67). Females were 294(95.5%) and 285(92.5%) were literate. Out of 308, 294 (95.5%) correctly identified that malaria was transmitted by mosquitoes. Two hundred and sixty three (85.4 %) RMCs had treated a child under five years for presumptive malaria in the two weeks preceding the survey. Out of 267 children, 232 (88.2%) received the correct dose of antimalarials and 220 (84.3%) were treated within 24 hours of onset of symptoms. Level of education was significantly found to affect receiving the correct dose of antimalarials.(

Field Epidemiology and Laboratory Training Programs in sub-Saharan Africa from 2004 to 2010: need, the process, and prospects

As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President’s Emergency Plan for AIDS Relief and the US President’s Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competencybased training for field epidemiologists and public health laboratory scientists providing a master’s degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a strategy to develop a locally trained public health workforce that can operate multi-disease surveillance and response systems.Key words: Field epidemiology, laboratory management, multi-disease surveillance and response systems, public health workforce capacity buildin

Short Communication - Hospital-Based Mortality in Federal Capital Territory Hospitals-Nigeria, 2005 - 2008

Background: Cause-specific mortality data are important to monitor trends in mortality over time. Medical records provide reliable documentation of the causes of deaths occurring in hospitals. This study describes all causes of mortality reported at hospitals in the Federal Capital Territory (FCT) of Nigeria. Methods: Deaths reported in 15 secondary and tertiary FCT hospitals occurring from January 1, 2005 and December 31, 2008 were identified by a retrospective review of hospital records conducted by the Nigeria Field Epidemiology and Laboratory Program (NFELTP). Data extracted from the records included sociodemographics, geographic area of residence and underlying cause-of-death information. Results: A total of 4,623 deaths occurred in the hospitals. Overall, the top five causes of death reported were: HIV 951 (21%), road traffic accidents 422 (9%), malaria 264 (6%), septicemia 206 (5%), and hypertension 194 (4%). The median age at death was 30 years (range: 0-100); 888 (20%) of deaths were among those less than one year of age. Among children < 1 year, low birth weight and infections were responsible for the highest proportion 131 (15%) of reported mortality. Conclusion: Many of the leading causes of mortality identified in this study are preventable. Infant mortality is a large public health problem in FCT hospitals. Although these findings are not representative of all FCT deaths, they may be used to quantify mortality in that occurs in FCT hospitals. These data combined with other mortality surveillance data can provide evidence to inform policy on public health strategies and interventions for the FCT