U.S. President's Malaria Initiative Impact Malaria Project, Jhpiego, Yaoundé, Cameroon.
U.S. President's Malaria Initiative Impact Malaria Project, Population Services International, Washington, District of Columbia.
Am J Trop Med Hyg. 2024 Feb 6;110(3_Suppl):76-82. doi: 10.4269/ajtmh.23-0528. Print 2024 Mar 5.
Malaria remains a main cause of morbidity and mortality in Cameroon. Since 2021, the U.S. President's Malaria Initiative Impact Malaria Project has supported the National Malaria Control Program to develop the Champions program in two northern regions. We assessed this program's preliminary effectiveness on the performance of hospitals in the management of severe malaria and reduction of malaria-related deaths. We conducted a secondary analysis of Outreach Training and Supportive Supervision (OTSS) data from four rounds (one round pre-Champions program and three rounds post-Champions program and 2020-2022 malaria-related mortality data for 12 hospitals). Using linear regressions, we measured changes in hospital readiness and competency of health workers in the management of severe malaria between baseline and subsequent rounds. There were statistically significant improvements in overall management of severe malaria scores in post-Champions OTSS rounds, with post-Champions round 3 exhibiting an increase of +14% (P = 0.013) over baseline. Overall health facility readiness scores exhibited an increase of +7% (P = 0.006) from baseline to post-Champions round 3. There were no statistically significant findings associated with providing the right treatment, as nearly all patients hospitalized with severe malaria were treated with a recommended severe malaria treatment. Reported inpatient malaria deaths and case fatality rates trended downward from 2020 to 2022, but these differences were not statistically significant. The Champions program resulted in significant improvements in quality of inpatient care for severe malaria. The downward trends in malaria deaths and case fatality rate will require further monitoring to determine whether the Champions program is having the desired impact of reducing inpatient deaths from malaria.
疟疾仍然是喀麦隆发病率和死亡率的主要原因。自 2021 年以来,美国总统疟疾倡议影响疟疾项目一直支持国家疟疾控制规划在两个北部地区开展冠军项目。我们评估了该项目在管理严重疟疾和减少疟疾相关死亡方面对医院绩效的初步效果。我们对来自四轮(一轮在冠军项目之前,三轮在冠军项目之后,以及 2020-2022 年与疟疾相关的 12 家医院的死亡数据)外联培训和支持性监督(OTSS)数据进行了二次分析。我们使用线性回归测量了基线和随后几轮之间医院对严重疟疾的准备情况和卫生工作者管理能力的变化。在冠军项目后的 OTSS 轮中,严重疟疾总体管理评分有统计学意义的提高,冠军项目后的第三轮比基线提高了+14%(P=0.013)。整体医疗机构准备评分从基线到冠军项目后的第三轮增加了+7%(P=0.006)。与提供正确治疗相关的发现没有统计学意义,因为几乎所有因严重疟疾住院的患者都接受了推荐的严重疟疾治疗。2020 年至 2022 年,报告的住院疟疾死亡和病死率呈下降趋势,但这些差异没有统计学意义。冠军项目显著提高了严重疟疾住院患者的护理质量。疟疾死亡和病死率的下降趋势需要进一步监测,以确定冠军项目是否对减少疟疾住院死亡产生了预期的影响。