Proactive community case management in Senegal 2014–2016: a case study in maximizing the impact of community case management of malaria

Gaye, Seynabou; Kibler, Janelle; Ndiaye, Jean Louis; Diouf, Mame Birame; Linn, Annē; Gueye, Alioune Badara; Fall, Fatou Ba; Ndiop, Médoune; Diallo, Ibrahima; Cisse, Moustapha; Ba, Mady; Thwing, Julie

doi:10.1186/s12936-020-03238-0

Cited by 42Malaria Research and ControlGlobal Maternal and Child HealthHistory of Medicine and Tropical Health

Proactive community case management in Senegal 2014–2016: a case study in maximizing the impact of community case management of malaria

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Gaye, Seynabou, Kibler, Janelle, Ndiaye, Jean Louis, Diouf, Mame Birame, Linn, Annē, Gueye, Alioune Badara, Fall, Fatou Ba, Ndiop, Médoune +4 more·2020·Malaria Journal

DOI 10.1186/s12936-020-03238-0PMC PMC7183580

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Abstract

The Senegal National Malaria Control Programme (NMCP) introduced home-based malaria management for all ages, with diagnosis by rapid diagnostic test (RDT) and treatment with artemisinin-based combination therapy (ACT) in 2008, expanding to over 2000 villages nationwide by 2014. With prise en charge à domicile (PECADOM), community health workers (CHWs) were available for community members to seek care, but did not actively visit households to find cases. A trial of a proactive model (PECADOM Plus), in which CHWs visited all households in their village weekly during transmission season to identify fever cases and offer case management, in addition to availability during the week for home-based management, found that CHWs detected and treated more cases in intervention villages, while the number of cases detected weekly decreased over the transmission season. The NMCP scaled PECADOM Plus to three districts in 2014 (132 villages), to a total of six districts in 2015 (246 villages), and to a total of 16 districts in 2016 (708 villages). A narrative case study with programmatic results is presented. During active sweeps over approximately 20 weeks, CHWs tested a mean of 77 patients per CHW in 2014, 89 patients per CHW in 2015, and 90 patients per CHW in 2016, and diagnosed a mean of 61, 61 and 43 patients with malaria per CHW in 2014, 2015 and 2016, respectively. The number of patients who sought care between sweeps increased, with a 104% increase in the number of RDTs performed and a 77% increase in the number of positive tests and patients treated with ACT during passive case detection. While the number of CHWs increased 7%, the number of patients receiving an RDT increased by 307% and the number of malaria cases detected and treated by CHWs increased 274%, from the year prior to PECADOM Plus introduction to its first year of implementation. Based on these results, approximately 700 additional CHWs in 24 new districts were added in 2017. This case study describes the process, results and lessons learned from Senegal’s implementation of PECADOM Plus, as well as guidance for other programmes considering introduction of this innovative strategy.

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Community case management of childhood illness, using proactive frequent home visitation, has shown promising results for reducing under-five mortality in Mali and improving access to care in Senegal, where CHWs are well supplied with needed medicines.
“Community case management of childhood illness, using proactive frequent home visitation, has shown promising results as a strategy for reducing under-five mortality in Mali and for improving access to care in Senegal, in which CHWs are well supplied with the medicines they need [43, 44].”
From Community health workers at the dawn of a new era: 11. CHWs leading the way to “Health for All” (2021) · cites this paper as [44]

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Additional file 3 of Expanding community case management of malaria to all ages can improve universal access to malaria diagnosis and treatment: results from a cluster randomized trial in Madagascar
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Additional file 3 of Proactive community case management decreased malaria prevalence in rural Madagascar: results from a cluster randomized trial
Ratovoson, R., Garchitorena, A., Kassié, D., Ravelonarivo, J., Andrianaranjaka, V., Razanatsiorimalala, S., Razafimandimby, A., Rakotomanana, F., Ohlstein, L., Mangahasimbola, R. T., et al. (2022) · Figshare · doi:10.6084/m9.figshare.21269326
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Additional file 1 of Expanding community case management of malaria to all ages can improve universal access to malaria diagnosis and treatment: results from a cluster randomized trial in Madagascar
Garchitorena, A., Harimanana, A. N., Irinantenaina, J., Razanadranaivo, H. L., Rasoanaivo, T. F., Sayre, D., Gutman, J. R., Mangahasimbola, R. T., Ravaoarimanga, M., Raobela, O., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26731591
Additional file 2 of Expanding community case management of malaria to all ages can improve universal access to malaria diagnosis and treatment: results from a cluster randomized trial in Madagascar
Garchitorena, A., Harimanana, A. N., Irinantenaina, J., Razanadranaivo, H. L., Rasoanaivo, T. F., Sayre, D., Gutman, J. R., Mangahasimbola, R. T., Ravaoarimanga, M., Raobela, O., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26731594
Additional file 2 of Proactive community case management decreased malaria prevalence in rural Madagascar: results from a cluster randomized trial
Ratovoson, R., Garchitorena, A., Kassié, D., Ravelonarivo, J., Andrianaranjaka, V., Razanatsiorimalala, S., Razafimandimby, A., Rakotomanana, F., Ohlstein, L., Mangahasimbola, R. T., et al. (2022) · Figshare · doi:10.6084/m9.figshare.21269323
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Scale-up of home-based management of malaria based on rapid diagnostic tests and artemisinin-based combination therapy in a resource-poor country: results in Senegal
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Community case management in malaria: review and perspectives after four years of operational experience in Saraya district, south-east Senegal
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Assessing the acceptability and feasibility of proactive community case management: A qualitative study in Chadiza District, ZambiaPreprint
Kabamba, B. M., Kangale, C. C., Simataa, M. N., Rutagwera, M.-R. I., Porter, T. R., Miller, J. M., Ferriss, E. L., Chibawe, C. P., Musunse, M., Nyendwa, P., et al. (2025) · medRxiv · doi:10.1101/2025.07.08.25331096 · Cited by 1 · see citing works
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Authors: Gaye, S., Kibler, J., Ndiaye, J. L., Diouf, M. B., Linn, A., Gueye, A. B., Fall, F. B., Ndiop, M., Diallo, I., Cisse, M., Ba, M., & Thwing, J.
Affiliations: Peace Corps (US)
Cheikh Anta Diop University (SN)
United States Agency for International Development (US)
Centers for Disease Control and Prevention (US)
Corresponding author: Thwing, Julie
ORCID: Ndiaye, Jean Louis
Linn, Annē
Ndiop, Médoune
Diallo, Ibrahima
Thwing, Julie
Venue: Malaria Journal
Publisher: Springer Science and Business Media LLC
Published: 2020-04-25
Volume: 19
Issue: 1
Pages: 166-166
ISSN: 1475-2875 (ISSN-L)
DOI: 10.1186/s12936-020-03238-0
PMC: PMC7183580
OpenAlex: W3020000076
Cited by: 42
References: 21
Citations by year: 2026: 1 · 2025: 8 · 2024: 16 · 2023: 4 · 2022: 8 · 2021: 4 · 2020: 1
FWCI: 3.18
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (tdm)
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Malaria Journal (publishedVersion, cc-by)
Research Square (acceptedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: US Presidents Malaria Initiative (not applicable)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Social Sciences › Arts and Humanities › History › History of Medicine and Tropical Health
Keywords: malaria, community health workers, active case finding, passive case detection, rapid diagnostic tests, artemisinin-based combination therapy, program scaling, malaria case detection
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Community Health Workers, Diagnostic Tests, Routine, Humans, Infant, Infant, Newborn, Malaria, Middle Aged, Senegal, Case Management, Young Adult

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Proactive community case management in Senegal 2014–2016: a case study in maximizing the impact of community case management of malaria

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