Case Management Bill Brieger | 01 Nov 2022 10:03 am
Reduction in Malaria Case Fatality Rate After Implementation of an Emergency Plan for Improved Case Management
Thierry Ouedraogo, Ousmane Badolo, Youssouf Sawadogo, Moumouni Bonkoungou, Francine Ouedraogo, Mathurin Bonzi, Gauthier Tougri, Alidou Sawadogo, Mathurin Dodo, Gladys Tetteh, and William Brieger report on Reduction in Malaria Case Fatality Rate After Implementation of an Emergency Plan for Improved Case Management in the Bittou Health District, Burkina Faso at the Annual Meeting of the American Society of Tropical Medicine and Hygiene in Seattle.
They observed that in Burkina Faso, malaria remained the leading cause of death between 2014 and 2021. In the Centre Est region, uncomplicated malaria cases among children under five years of age were 11% of the country’s total (3,679,128 cases) and severe malaria cases were 9% of the country’s total (211,093 cases) in 2014. This region, is subdivided into 7 health districts including Bittou.
In 2014, the malaria case-fatality rate (CFR) among children under five years of age in Bittou (1.39%) was higher than the average for all districts in the Centre Est region (1.08). To remedy this situation, the Bittou health district management team (HDMT) implemented an emergency plan in 2016.
The plan included five components: i) sensitization of health facility staff to enable the rapid referral of severe malaria cases to the district hospital (CMA); ii) reorganization of CMA pediatric emergency management to make a physician the first point of contact; iii) Ensuring availability of supplies for severe malaria case management, including the availability of blood; iv) daily medical check-ups of hospitalized patients, and v) reinforcement of skills all HFs.
Other improvements in the health system that were introduced around the same time, but were not part of the emergency plan, included: i) free care for children under 5 years of age; ii) municipal financing of ambulance fuel for transferring patients referred; iii) free blood collection; iv) free telephone calls between the health structures; v) the presence of 5 doctors at the CMA, and vi) coaching and increased dynamism of the HDMT.
After implementation of the emergency plan, the malaria CFR in Bittou went from 1.39% in 2014, and 1.52% in 2015 to 0% in 2016 and 2017, 0.2% in 2018, 0% in 2019, 0.07% in 2020 and 0.05% in 2021. Malaria control remains a challenge in Burkina Faso. However, the improved CFRs seen in Bittou show that effective involvement of HDMT could potentially contribute to substantial reductions in malaria mortality.