Effectiveness of Smartphone-Based Community Case Management on the Urgent Referral, Reconsultation, and Hospitalization of Children Aged Under 5 Years in Malawi: Cluster-Randomized, Stepped-Wedge Trial

Background: Integrated community case management (CCM) has led to reductions in child mortality in Malawi resulting from illnesses such as malaria, pneumonia, and diarrhea. However, adherence to CCM guidelines is often poor, potentially leading to inappropriate clinical decisions and poor outcomes....

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Veröffentlicht in:Journal of medical Internet research 2021-10, Vol.23 (10), p.e25777-e25777
Hauptverfasser: Chirambo, Griphin Baxter, Thompson, Matthew, Hardy, Victoria, Ide, Nicole, Hwang, Phillip H, Dharmayat, Kanika, Mastellos, Nikolaos, Heavin, Ciara, O'Connor, Yvonne, Muula, Adamson S, Andersson, Bo, Carlsson, Sven, Tran, Tammy, Hsieh, Jenny Chen-Ling, Lee, Hsin-Yi, Fitzpatrick, Annette, Joseph Wu, Tsung-Shu, O'Donoghue, John
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Sprache:eng
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Zusammenfassung:Background: Integrated community case management (CCM) has led to reductions in child mortality in Malawi resulting from illnesses such as malaria, pneumonia, and diarrhea. However, adherence to CCM guidelines is often poor, potentially leading to inappropriate clinical decisions and poor outcomes. We determined the impact of an e-CCM app on the referral, reconsultation, and hospitalization rates of children presenting to village clinics in Malawi. Objective: We determined the impact of an electronic version of a smartphone-based CCM (e-CCM) app on the referral, reconsultation, and hospitalization rates of children presenting to village clinics in Malawi. Methods: We used a stepped-wedge, cluster-randomized trial to compare paper-based CCM (control) with and without the use of an e-CCM app on smartphones from November 2016 to February 2017. A total of 102 village clinics from 2 districts in northern Malawi were assigned to 1 of 6 clusters, which were randomized on the sequencing of the crossover from the control phase to the intervention phase as well as the duration of exposure in each phase. Children aged ≥2 months to
ISSN:1438-8871
1439-4456
1438-8871
DOI:10.2196/25777