Evaluation of the Management of Childhood Febrile Illness in Zambia

Project Description

Until recently, febrile illness among children in malaria-endemic regions was presumed to be due to malaria, and empirical treatment initiated in most cases. However, in the past decade, substantial progress has been achieved in the control of malaria in much of sub-Saharan Africa.

Both over-diagnosis and under-diagnosis of malaria have significant implications: Failure to diagnose true cases of malaria results in withholding treatment from patients who would benefit from timely and effective antimalarial therapy. Conversely (and increasingly more importantly), incorrectly attributing fever to malaria risks missing a potentially life-threatening alternative diagnosis (such as a severe bacterial infection), in addition to exposing patients unnecessarily to the side-effects and cost of antimalarial therapy – and promoting resistance to artemisinin-based therapy on a population level.

The goal of this study is to gather information that will enable MACEPA and the Zambia Center for Applied Health Research and Development (ZCAHRD) to support the Government of Zambia to scale up good practice in the management of febrile illness in children during a period of changing malaria epidemiology in the country.

The two overall objectives of this study are to:

  • Conduct in-depth interviews with Zambian Ministry officials (Ministry of Health [MOH] and Ministry of Community Development, Mother and Child Health [MCDMCH]) and Zambia faith-based and other non-governmental partners involved in policy development, program planning and implementation, and monitoring & evaluation activities, in order to gain an understanding of key experts’ perspectives on current policies, guidelines, practices, and related implementation challenges with regard to the identification of febrile illness in children under 5,  its diagnosis, and appropriate treatment across the health system – with an emphasis on the public sector, but inclusive of the private sector. (Qualitative component)
  • Evaluate current practices and standards of care for childhood febrile illness in both public and mission facilities at different levels of the health care system in Southern Province in the context of aggressive malaria control and elimination efforts. (Quantitative component)

Primary outcome:

  • Proportion of children under 5 years old with febrile illness managed according to the standard of care prescribed by the MOH

    Project Details

    Principal Investigator Davidson Hamer
    Boston University Co-Investigators Toyin Ajayi, Godfrey Biemba, Karsten Lunze, William MacLeodKojo Yeboah-Antwi
    Collaborators PATH
    Country(ies) Zambia
    Dates of Research 2013-2014
    Donor/Funder PATH