Nigerian Journal of Clinical Practice

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Effectiveness of trained community volunteers in improving knowledge and management of childhood malaria in a rural area of Rivers State, Nigeria

CI Tobin‑West, NCT Briggs


Introduction: Malaria accounts for 70% of illnesses and 30% of deaths among children under 5 years in Nigeria. This study was aimed at determining the effectiveness of trained community volunteers in delivering multiple anti‑malaria interventions to achieve rapid reduction in morbidity and mortality among under 5 children.
Materials and Methods: A quasi‑experimental study was carried out in two rural communities in Rivers State, Nigeria among 368 mothers/caregivers. A set of 184 of the mothers/caregivers (experimental group) were trained on malaria and provided with bed nets and drugs  (artemisinin‑lumefantrine) to treat children under 5 years who developed fever during the period of the experiment. Another set of 184 mothers/caregivers (controls) did not receive similar training and drugs. Both groups were compared at baseline and after 6 months of the experiment on their knowledge of malaria prevention and treatment. Level of significance was set at P = 0.05.
Results: In the experimental group: Adequate knowledge about malaria increased from 115 (62.5%) to 175 (95.1%) (P < 0.0001), early commencement of treatment of fever increased from 68 (37.0%) to 131 (75.7%) (P < 0.0001), and children cured of malaria increased from 87 (47.3%) to 146 (84.4%) (P < 0.0001). Insecticide‑treated bed nets use also increased from 86 (46.7%) to 161 (87.5%) (P < 0.0001). There were no significant changes in the control group.
Conclusions: The study demonstrated the inherent potentials in using community‑based volunteers in malaria preventionand control for those in rural areas with poor health service delivery. We advocate its adaptation for far‑reaching reduction in childhood morbidity and mortality and rapid attainment of millennium development goals 4.

Key words: Community volunteers, malaria, Nigeria, task shifting, under ‑ 5 children
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