Towards home- and community-based approaches for managing childhood fever in malaria endemic areas

Febrile illnesses associated with malaria and pneumonia account for a large proportion of child mortality in sub-Saharan Africa. Three sub-studies were conducted to contribute to the development and evaluation of programs to improve home and community management of childhood fever. The first sub-study evaluated the ability of caregivers to identify fever in their child using palpation through a systematic review. Combination of results from 12 studies demonstrated that caregivers perform well in identifying fever. The second sub-study explored the nature and determinants of caregiver fever management practices using logistic regression and community-level data from Uganda. Caregiver education level, child age and household size were associated with home treatment while distance, region and initial home treatment practices were associated with care seeking. Clustering of fever management practices was significant at the village level. The third sub-study prepared a set of proposal guidelines and sample size framework for a multicentre, cluster-randomized trial of an integrated approach