Acceptability of pre-referral rectal artesunate for severe malaria in children under 5 years by health workers and caregivers in the Democratic Republic of the Congo, Nigeria and Uganda

• Published in: Malaria journal 2022-11, Vol.21 (1), p.322-8, Article 322
• Main Authors: Awor, Phyllis, Kimera, Joseph, Athieno, Proscovia, Tumukunde, Gloria, Okitawutshu, Jean, Tshefu, Antoinette, Omoluabi, Elizabeth, Signorell, Aita, Brunner, Nina, Kalenga, Jean-Claude, Akano, Babatunde, Ayodeji, Kazeem, Okon, Charles, Yusuf, Ocheche, Delvento, Giulia, Lee, Tristan, Burri, Christian, Lengeler, Christian, Hetzel, Manuel W
• Format: Article
• Language: English
• Subjects: Acceptability; Age; Antimalarials - therapeutic use; Artemisinins - therapeutic use; Artesunate; Artesunate - therapeutic use; Caregivers; Child; Child, Preschool; Children; Communicable diseases in children; Community Health Workers; Data collection; Democratic Republic of the Congo; Drug therapy; Field study; Health attitudes; Health care; Health facilities; Health surveillance; Households; Human diseases; Humans; Illnesses; Interviews; Local government; Malaria; Malaria - drug therapy; Malaria - epidemiology; Medical personnel; Medical research; Nigeria - epidemiology; Polls & surveys; Preventable deaths; Public health; Rectum; Rectum, Medication by; Referral and Consultation; Research ethics; Research projects; Surveys; Teams; Uganda - epidemiology; Vector-borne diseases; Workers
• ISSN: 1475-2875; 1475-2875
• DOI: 10.1186/s12936-022-04348-7

For children below 6 years with suspected severe malaria attending a health care provider unable to provide parenteral malaria treatment, pre-referral rectal artesunate (RAS) is recommended by the World Health Organization to prevent death and disability. A number of African countries are in the process of rolling out quality-assured RAS for pre-referral treatment of severe malaria at community-level. The success of RAS depends, among other factors, on the acceptability of RAS in the communities where it is being rolled-out. Yet to date, there is limited literature on RAS acceptability. This study aimed to determine the acceptability of RAS by health care providers and child caregivers in communities where quality assured RAS was rolled out. This study was nested within the comprehensive multi-country observational research project Community Access to Rectal Artesunate for Malaria (CARAMAL), implemented in the Democratic Republic of the Congo (DRC), Nigeria, and Uganda between 2018 and 2020. Data from three different sources were analysed to understand RAS acceptability: interviews with health workers during three health care provider surveys (N = 341 community health workers and 467 primary health facility workers), with caregivers of children