Community-Level Management of Unclassified Fever

TRAction is leading the way in researching the safety and efficacy of a new strategy for managing unclassified fever in children at the community level. The purpose of the research is to explore the safety of a systematic versus conditional 3-day follow up visit by a community health worker (CHW) for children with uncomplicated fever. There is limited evidence on which of the two interventions is safer for the child. This research will have significant implications for Community Health Worker policy in both countries and will influence guidelines related to treatment of fever at the community level. The results may lead to a simpler and more efficient iCCM algorithm for treatment of fever that could reduce unnecessary follow-up visits. This would potentially avoid costs and time for CHWs and caregivers, unnecessary antimicrobial treatment for febrile children, and promote more consistent and credible messages to caregivers.

Key Results

As of April 2016, both the International Rescue Committee and Malaria Consortium have enrolled more than 2,000 children into their studies. Both research teams are on track to reach their desired sample size. More results will be forthcoming following data analysis.

Our Partners

International Rescue Committee
Malaria Consortium

Collaborative Efforts

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Unclassified Fever in DRC

Malisi (HIV positive) and her daughter Shalom wait for transport home after receiving treatment in Arua, Uganda, because treatment is not available in the DR Congo where they live. © 2012 Annemarie Boks/AIMNL, Courtesy of Photoshare

COMMUNITY-LEVEL MANAGEMENT OF UNCLASSIFIED FEVER

The aim of this study is to assess the safety of a WHO-recommended systematic 3-day follow up for children with unclassified fever compared to a conditional visit on non-resolution of symptoms. There is limited evidence on which of the two recommendations is safer for the child and it is unclear whether caregivers of children actually come back promptly to the health post for a conditional follow-up visit if the child is not improving. Research questions include:

How many children develop complications as a result of delayed referral?
What is the outcome of illness in those children where symptoms do not resolve?
What is the rate of hospitalization up to Day 7?

Implemented by International Rescue Committee and Johns Hopkins University Bloomberg School of Public Health

Location: Tanganyika District, Democratic Republic of Congo

Timeline: April 2015 - October 2015

Unclassified Fever in Ethiopia

Children wait outside the new frontline health care post in their village, Mosebo, which is about three hours outside of Bahir Dar in Ethiopia. © 2014 Nicole M. Melancon, Courtesy of Photoshare

COMMUNITY-LEVEL MANAGEMENT OF UNCLASSIFIED FEVER IN ETHIOPIA

How many children develop complications as a result of delayed referral?
What is the outcome of illness in those children where symptoms do not resolve?
What is the rate of hospitalization up to Day 7?

Implemented by Malaria Consortium

Location: Southern Nations, Nationalities, and People's Regional State, Ethiopia

Timeline: March 2015 - October 2015

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The Translating Research into Action project is funded by the U.S. Agency for International Development (USAID) under cooperative agreement GHS-A-00-09-00015-00. The information provided on this web site is not official U.S. Government information and does not represent the views or positions of the U.S. Agency for International Development or the U.S. Government.

Community-Level Management of Unclassified Fever

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