September 01, 2011
1 min read

Texts improved malaria treatment adherence among HCWs in Kenya

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Text message reminders sent to health care workers’ personal mobile phones significantly improved adherence to malaria case management guidelines, according to new findings published in The Lancet.

“In resource limited settings, malaria control programs should consider use of text-messaging to improve clinical practices,” Dejan Zurovac, PhD, of the Kenya Medical Research Institute-Wellcome Trust Research Programme in Africa, told Infectious Disease News.

Malaria case-management practices of health care workers (HCWs) are often different from recommended guidelines, according to background information in the study. For the cluster-randomized controlled trial, Zurovac and colleagues used text messaging to remind HCWs to adhere to national treatment guidelines, and evaluated whether this could improve and maintain their adherence to guidelines for outpatient cases in children.

Dejan Zurovac, PhD
Dejan Zurovac, PhD

Between March 2009 and May 2010, 107 health facilities across coastal and western Kenya were randomly assigned to either the text message intervention for 6 months or to a control group (no text messages). The researchers then assessed case management practices among 1,157 children in the intervention group and 1,112 in the control group.

After the intervention was implemented, text message reminders improved artemether-lumefantrine management practices by 23.7% (95%CI, 7.6-40), and by 24.5% (95%CI, 8.1- 41) 6 months after the intervention was implemented.

Further, the researchers observed an increase in the proportion of children who received their first dose of artemisinin combo therapies from a health facility; and an increase in children who were told how to administer the rest of the treatment course.

In an accompanying editorial, Bruno Moonen, MD and Justin M. Cohen, PhD, both from the Clinton Health Access Initiative in Nairobi, Kenya, said that a combination of interventions will most likely be needed to improve adherence to national guidelines to acceptable levels. “Zurovac and colleagues provide strong evidence that text-message reminders can be an effective, low-cost component of such a package; rigorous assessment of how additional interventions — both traditional and innovative — can be combined with these efforts will be needed to achieve maximum effect and ensure that donors are aware of the value of continued investment in such strategies.” – by Ashley DeNyse

For more information:

  • Moonen B. Lancet. 2011;doi:10.1016/s0140-6736(11)61089-1.
  • Zurovac D. Lancet. 2011;doi:10.1016/S0140-6736(11)60783-6.

Disclosure: This research was funded by The Wellcome Trust.

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