Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study

Abstract Health system constraints hamper treatment of children with severe acute malnutrition (SAM) in Tanzania. This non-inferiority quasi-experimental study in Bariadi (intervention) and Maswa (control) districts assessed the effectiveness, coverage, and cost-effectiveness of SAM treatment by com...

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Autores principales: Calistus Wilunda, Fortihappiness Gabinus Mumba, Giovanni Putoto, Gloria Maya, Elias Musa, Vincenza Lorusso, Chacha Magige, Germana Leyna, Fabio Manenti, Donata Dalla Riva, Bupe Abel Ntoga, Giulia Segafredo
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Publicado: Nature Portfolio 2021
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spelling oai:doaj.org-article:9673a539c74b41b3bfd405f4cce708932021-12-02T13:57:38ZEffectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study10.1038/s41598-021-81811-62045-2322https://doaj.org/article/9673a539c74b41b3bfd405f4cce708932021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81811-6https://doaj.org/toc/2045-2322Abstract Health system constraints hamper treatment of children with severe acute malnutrition (SAM) in Tanzania. This non-inferiority quasi-experimental study in Bariadi (intervention) and Maswa (control) districts assessed the effectiveness, coverage, and cost-effectiveness of SAM treatment by community health workers (CHWs) compared with outpatient therapeutic care (OTC). We included 154 and 210 children aged 6–59 months with SAM [mid-upper arm circumference (MUAC) < 11.5 cm] without medical complications in the control and intervention districts, respectively. The primary treatment outcome was cure (MUAC ≥ 12.5 cm). We performed costing analysis from the provider’s perspective. The probability of cure was higher in the intervention group (90.5%) than in the control group (75.3%); risk ratio (RR) 1.17; 95% CI 1.05, 1.31 and risk difference (RD) 0.13; 95% CI 0.04, 0.23. SAM treatment coverage was higher in the intervention area (80.9%) than in the control area (41.7%). The cost per child treated was US$146.50 in the intervention group and US$161.62 in the control group and that per child cured was US$161.77 and US$215.49 in the intervention and control groups, respectively. The additional costs per an additional child treated and cured were US$134.40 and US$130.92, respectively. Compared with OTC, treatment of children with uncomplicated SAM by CHWs was effective, increased treatment coverage and was cost-effective.Calistus WilundaFortihappiness Gabinus MumbaGiovanni PutotoGloria MayaElias MusaVincenza LorussoChacha MagigeGermana LeynaFabio ManentiDonata Dalla RivaBupe Abel NtogaGiulia SegafredoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Calistus Wilunda
Fortihappiness Gabinus Mumba
Giovanni Putoto
Gloria Maya
Elias Musa
Vincenza Lorusso
Chacha Magige
Germana Leyna
Fabio Manenti
Donata Dalla Riva
Bupe Abel Ntoga
Giulia Segafredo
Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study
description Abstract Health system constraints hamper treatment of children with severe acute malnutrition (SAM) in Tanzania. This non-inferiority quasi-experimental study in Bariadi (intervention) and Maswa (control) districts assessed the effectiveness, coverage, and cost-effectiveness of SAM treatment by community health workers (CHWs) compared with outpatient therapeutic care (OTC). We included 154 and 210 children aged 6–59 months with SAM [mid-upper arm circumference (MUAC) < 11.5 cm] without medical complications in the control and intervention districts, respectively. The primary treatment outcome was cure (MUAC ≥ 12.5 cm). We performed costing analysis from the provider’s perspective. The probability of cure was higher in the intervention group (90.5%) than in the control group (75.3%); risk ratio (RR) 1.17; 95% CI 1.05, 1.31 and risk difference (RD) 0.13; 95% CI 0.04, 0.23. SAM treatment coverage was higher in the intervention area (80.9%) than in the control area (41.7%). The cost per child treated was US$146.50 in the intervention group and US$161.62 in the control group and that per child cured was US$161.77 and US$215.49 in the intervention and control groups, respectively. The additional costs per an additional child treated and cured were US$134.40 and US$130.92, respectively. Compared with OTC, treatment of children with uncomplicated SAM by CHWs was effective, increased treatment coverage and was cost-effective.
format article
author Calistus Wilunda
Fortihappiness Gabinus Mumba
Giovanni Putoto
Gloria Maya
Elias Musa
Vincenza Lorusso
Chacha Magige
Germana Leyna
Fabio Manenti
Donata Dalla Riva
Bupe Abel Ntoga
Giulia Segafredo
author_facet Calistus Wilunda
Fortihappiness Gabinus Mumba
Giovanni Putoto
Gloria Maya
Elias Musa
Vincenza Lorusso
Chacha Magige
Germana Leyna
Fabio Manenti
Donata Dalla Riva
Bupe Abel Ntoga
Giulia Segafredo
author_sort Calistus Wilunda
title Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study
title_short Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study
title_full Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study
title_fullStr Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study
title_full_unstemmed Effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in Simiyu region, Tanzania: a quasi-experimental pilot study
title_sort effectiveness of screening and treatment of children with severe acute malnutrition by community health workers in simiyu region, tanzania: a quasi-experimental pilot study
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/9673a539c74b41b3bfd405f4cce70893
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