Young children with simple and severe malaria in remote areas of the DRC: analysis of the access to care in kapolowe health zone
PhD summary
It is well known that the outcomes of severe malaria and of severe sepsis are critically dependent on rapid access to health care and immediate treatment. For untreated severe malaria, the mortality approaches 100% while prompt treatment with effective antimalarial and supportive care reduces this rate to 10-20%. It is essential that full course of effective parenteral (or rectal) antimalarial treatment be given promptly in the initial treatment of severe malaria. Although, the clinical outcomes for CARAMAL were poor because of non-completion of referral (due to any reason) thereby resulting in non-completion of full treatment. SEMAReACT study would evaluate alternate treatment in cases where referral is refused or not possible, i.e. RAS + 3-day ACT in community care settings. Therefore, this study aims to explore the factors affecting health care-seeking behavior, from the first signs of illness to the first contact for health care from the perspective of caretakers (parents), and to document their perceptions regarding the acceptability and feasibility of CHWs using pre-referral RAS, to analyze the interaction between the perspectives of medical personnel and mothers of children aged 6 months to 5 years in the management of simple and severe malaria and to evaluate the impact of the reinforcement by artesunate in capsules at the ICCM in the outskirts of the Kapolowe health zone, on HSB and access to care.
To successfully implement this in a community, it is crucial to understand the context of parents' care-seeking behavior for critically ill children and to gain insight into their perceptions and attitudes towards the use of pre-referral RAS by community health workers (CHWs) with this in mind, my PHD will fit within the Horizon Europe SEMA-ReACT (Severe malaria in Remote Areas: Closing the Evidence Gap) project.
Our study would like to make its contribution, since children living in remote areas with limited access to health facilities are still too often dying because they don't get these effective treatments in time. At the community level, where parenteral drug administration is not possible, a pre-referral RAS intervention has the potential to reduce morbidity and mortality. Therefore it is important To understand the treatment-seeking behavior of children's mothers in the context of simple and severe malaria in children aged between 6 months and 5 years ,To explore and understand the management of simple and severe malaria from the point of view of carers and mothers of children aged 6 months to 5 years, in order to highlight their interaction ,To describe the therapeutic itineraries, the experiences drawn from the practices of management of simple and severe malaria of mothers of children aged 6 months to 5 years and the evolution during the implementation of the study in the Kapolowe health zone and to analyze the population's perception and attitudes of artesunate capsules.