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Background <p>Proactive community case management (ProCCM) of malaria is a strategy to improve access to prompt and effective case management of malaria at the community level by supporting community health workers (CHWs) to visit every household in their community every 1 to 2&#xa0;weeks to identify people with malaria symptoms, offer rapid diagnostic tests, and first line malaria treatment for those with positive tests. We sought to determine if this strategy could decrease malaria parasite prevalence in high malaria transmission settings.</p> Methods <p>CHWs in the intervention (ProCCM) arm were asked to visit households proactively twice per month to offer an extensive package of maternal and child health services, including malaria case management for males and females of all ages, compared to those in the control arm that offered these services from a fixed point in the community. We measured parasite prevalence among all ages, and fever prevalence, care seeking, and access to diagnostic testing among children under 5&#xa0;years at the endline survey of a 3-year cluster-randomized controlled trial of ProCCM, covering a population of over 100,000 in Bankass, Mali, a remote rural area that became a conflict zone during the study period.</p> Results <p>There was no difference between intervention and control arms in parasite prevalence among all ages, fever in the last 2&#xa0;weeks, care seeking, or access to diagnostic testing for malaria among children under 5&#xa0;years. However, CHWs in the intervention arm reached the goal of two visits per month in less than half the households.</p> Conclusions <p>In this high transmission setting, with well-supported, supplied, supervised, and compensated CHWs, both fixed point (control) and proactive household (intervention) visits offered comparable benefits in extending access to malaria case management to community members, despite intervention arm CHWs not reaching the target household visit frequency.</p> <p><i>Trial registration</i> Trial registration number NCT02694055 (registered February 26, 2016).</p>

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Impact of proactive community case management of malaria on malaria prevalence in Bankass, Mali: a cluster-randomised controlled trial

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月20日

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  • Julie Thwing,
  • Saibou Doumbia,
  • Aliou Traore,
  • Mahamadou Sylla,
  • Mahamadou Sogoba,
  • Idrissa Kamara,
  • Yacouba Samaké,
  • Lamine Guindo,
  • Stephanie Rapp,
  • Emily Treleaven,
  • Calvin Chiu,
  • Caroline Whidden,
  • Aminatou Kone,
  • Abdoulaye A. Djimde,
  • Ari D. Johnson,
  • Kassoum Kayentao

摘要

Background

Proactive community case management (ProCCM) of malaria is a strategy to improve access to prompt and effective case management of malaria at the community level by supporting community health workers (CHWs) to visit every household in their community every 1 to 2 weeks to identify people with malaria symptoms, offer rapid diagnostic tests, and first line malaria treatment for those with positive tests. We sought to determine if this strategy could decrease malaria parasite prevalence in high malaria transmission settings.

Methods

CHWs in the intervention (ProCCM) arm were asked to visit households proactively twice per month to offer an extensive package of maternal and child health services, including malaria case management for males and females of all ages, compared to those in the control arm that offered these services from a fixed point in the community. We measured parasite prevalence among all ages, and fever prevalence, care seeking, and access to diagnostic testing among children under 5 years at the endline survey of a 3-year cluster-randomized controlled trial of ProCCM, covering a population of over 100,000 in Bankass, Mali, a remote rural area that became a conflict zone during the study period.

Results

There was no difference between intervention and control arms in parasite prevalence among all ages, fever in the last 2 weeks, care seeking, or access to diagnostic testing for malaria among children under 5 years. However, CHWs in the intervention arm reached the goal of two visits per month in less than half the households.

Conclusions

In this high transmission setting, with well-supported, supplied, supervised, and compensated CHWs, both fixed point (control) and proactive household (intervention) visits offered comparable benefits in extending access to malaria case management to community members, despite intervention arm CHWs not reaching the target household visit frequency.

Trial registration Trial registration number NCT02694055 (registered February 26, 2016).