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Wednesday 26th June 2019

Texts could improve malaria care

8th August 2011

Researchers in Kenya who carried out a six-month trial into malaria care delivery found that daily text message reminders to health workers could boost the treatment of children.


The results showed that nearly 25% more children received the correct treatment for malaria when the healthcare workers received the reminders.

Writing in The Lancet, the team said they had sent text message reminders to health workers urging them to check up on their patients and reminding them of the procedures they needed to follow.

Similar techniques would cost very little and be easily extended nationwide, they concluded.

The reminders, which help ensure that patients stay on track with their medication, could save many lives and reduce the risk of drug resistance.

As much as 90% of the 800,000 people who die annually of malaria are in African countries.

Many of them are children under five years old, and an African child dies of the disease every 45 seconds, according to figures from the World Health Organisation (WHO).

The WHO documents a total of 240 million cases of the mosquito-borne disease worldwide each year.

If patients fail to stick to and complete their malaria treatment programmes, their recovery can be affected.

Incomplete treatment also gives the malaria parasite a chance to develop resistance against current frontline therapies.

Health workers across Africa still routinely fail to ensure the treatment is correctly delivered, however.

For the purposes of the study, 119 health workers were chosen from 107 rural health facilities across Kenya. They were randomly assigned them to receive text-message reminders or not.

The text messages were sent to the health workers between March 2009 and May 2010, reminding them how to assess or manage potential malaria cases.

They were based on national health guidelines for malaria treatment issued by the Kenyan government. They would remind health workers to talk to the mother, to check all sick children for malaria, and to make sure they touched the child they were examining.

They also including an inspirational phrase or quote, such as "actions speak louder than words.'

Health workers who received the texts saw a 25% improvement in the level of care provided to patients with malaria.

A larger proportion of patients were give prompt anti-malarial treatment with the test message service than without, and more of them were given the right advice, the study showed.

According to Dejan Zurovac of the Kenya Medical Research Institute-Wellcome Trust Research Programme in Nairobi, the trial showed conclusively that text reminders can improve health workers' adherence to treatment guidelines for malaria.

Mobile phones are common Kenya, which has 22 million mobile phone subscribers, or 86% percent of the population on mobile networks, and text messaging is increasingly being used in conjunction with healthcare.

The Kenyan team said their text message reminder system could be scaled up quickly and successfully, because it costs just one US cent to send a text message in Kenya.

Overall, a programme like theirs should cost around US$2.60 per health worker, adding up to US$39,000 if rolled out to health workers nationwide.

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