@article{fdi:010086330,
  title = {{P}roactive community case management decreased malaria prevalence in rural {M}adagascar : results from a cluster randomized trial},
  author = {{R}atovoson, {R}. and {G}architorena, {A}ndres and {K}assie, {D}. and {R}avelonarivo, {J}. {A}. and {A}ndrianaranjaka, {V}. and {R}azanatsiorimalala, {S}. and {R}azafimandimby, {A}. and {R}akotomanana, {F}. and {O}hlstein, {L}. and {M}angahasimbola, {R}. and {R}andrianirisoa, {S}. {A}. {N}. and {R}azafindrakoto, {J}. and {D}entinger, {C}. {M}. and {W}illiamson, {J}. and {K}apesa, {L}. and {P}iola, {P}. and {R}andrianarivelojosia, {M}. and {T}hwing, {J}. and {S}teinhardt, {L}. {C}. and {B}aril, {L}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {M}alaria remains a leading cause of morbidity and mortality worldwide, with progress in malaria control stalling in recent years. {P}roactive community case management (pro-{CCM}) has been shown to increase access to diagnosis and treatment and reduce malaria burden. {H}owever, lack of experimental evidence may hinder the wider adoption of this intervention. {W}e conducted a cluster randomized community intervention trial to assess the efficacy of pro-{CCM} at decreasing malaria prevalence in rural endemic areas of {M}adagascar. {M}ethods {T}wenty-two fokontany (smallest administrative unit) of the {M}ananjary district in southeast {M}adagascar were selected and randomized 1:1 to pro-{CCM} (intervention) or conventional integrated community case management (i{CCM}). {R}esidents of all ages in the intervention arm were visited by a community health worker every 2 weeks from {M}arch to {O}ctober 2017 and screened for fever; those with fever were tested by a rapid diagnostic test ({RDT}) and treated if positive. {M}alaria prevalence was assessed using {RDT}s on all consenting study area residents prior to and following the intervention. {H}emoglobin was measured among women of reproductive age. {I}ntervention impact was assessed via difference-in-differences analyses using logistic regressions in generalized estimating equations. {R}esults {A} total of 27,087 and 20,475 individuals participated at baseline and endline, respectively. {M}alaria prevalence decreased from 8.0 to 5.4% in the intervention arm for individuals of all ages and from 6.8 to 5.7% in the control arm. {P}ro-{CCM} was associated with a significant reduction in the odds of malaria positivity in children less than 15 years ({OR} = 0.59; 95% {CI} [0.38-0.91]), but not in older age groups. {T}here was no impact on anemia among women of reproductive age. {C}onclusion {T}his trial suggests that pro-{CCM} approaches could help reduce malaria burden in rural endemic areas of low- and middle-income countries, but their impact may be limited to younger age groups with the highest malaria burden.},
  keywords = {{M}alaria detection ; {C}ommunity case management ; {R}ural ; {M}adagascar ; {MADAGASCAR}},
  booktitle = {},
  journal = {{BMC} {M}edicine},
  volume = {20},
  numero = {1},
  pages = {322 [15 ]},
  ISSN = {1741-7015},
  year = {2022},
  DOI = {10.1186/s12916-022-02530-x},
  URL = {https://www.documentation.ird.fr/hor/fdi:010086330},
}