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Dejan Zurovac

Elvire Mfueni, Brecht Devleesschauwer, Angel Rosas-Aguirre, Carine Van Malderen, Patrick T Brandt, Bernhards Ogutu, Robert W Snow, Léon Tshilolo, Dejan Zurovac, Dieter Vanderelst, Niko Speybroeck
BACKGROUND: Malaria is one of the major causes of childhood death in sub-Saharan countries. A reliable estimation of malaria prevalence is important to guide and monitor progress toward control and elimination. The aim of the study was to estimate the true prevalence of malaria in children under five in the Democratic Republic of the Congo, Uganda and Kenya, using a Bayesian modelling framework that combined in a novel way malaria data from national household surveys with external information about the sensitivity and specificity of the malaria diagnostic methods used in those surveys-i...
February 5, 2018: Malaria Journal
Mitsuru Toda, Dejan Zurovac, Ian Njeru, David Kareko, Matilu Mwau, Kouichi Morita
BACKGROUND: The correct knowledge of standard case definition is necessary for frontline health workers to diagnose suspected diseases across Africa. However, surveillance evaluations commonly assume this prerequisite. This study assessed the knowledge of case definitions for health workers and their supervisors for disease surveillance activities in rural Kenya. METHODS: A cross-sectional survey including 131 health workers and their 11 supervisors was undertaken in two counties in Kenya...
January 17, 2018: BMC Public Health
Caroline Jones, Ambrose O Talisuna, Robert W Snow, Dejan Zurovac
BACKGROUND: Adherence to anti-malarial medication is highly variable but frequently suboptimal. Numerous interventions with a variety of methodological approaches have been implemented to address the problem. A recently conducted, randomized, controlled trial in western Kenya evaluated the effects of short message service (SMS) reminders on paediatric adherence to artemether-lumefantrine (AL) and found over 97% adherence rates in both intervention and control arms. The current study was undertaken to explore participants' experiences in the trial and identify the factors contributing to the high adherence rates...
January 5, 2018: Malaria Journal
Mitsuru Toda, Ian Njeru, Dejan Zurovac, David Kareko, Shikanga O-Tipo, Matilu Mwau, Kouichi Morita
Outbreaks of epidemic diseases pose serious public health risks. To overcome the hurdles of sub-optimal disease surveillance reporting from the health facilities to relevant authorities, the Ministry of Health in Kenya piloted mSOS (mobile SMS-based disease outbreak alert system) in 2013-2014. In this paper, we report the results of the qualitative study, which examined factors that influence the performances of mSOS implementation. In-depth interviews were conducted with 11 disease surveillance coordinators and 32 in-charges of rural health facilities that took part in the mSOS intervention...
2017: PloS One
Martin Njoroge, Dejan Zurovac, Esther A A Ogara, Jane Chuma, Doris Kirigia
BACKGROUND: The growth of Information and Communication Technology in Kenya has facilitated implementation of a large number of eHealth projects in a bid to cost-effectively address health and health system challenges. This systematic review aims to provide a situational analysis of eHealth initiatives being implemented in Kenya, including an assessment of the areas of focus and geographic distribution of the health projects. The search strategy involved peer and non-peer reviewed sources of relevant information relating to projects under implementation in Kenya...
February 10, 2017: BMC Research Notes
Ambrose O Talisuna, Amos Oburu, Sophie Githinji, Josephine Malinga, Beatrice Amboko, Philip Bejon, Caroline Jones, Robert W Snow, Dejan Zurovac
BACKGROUND: Short Message Service (SMS) reminders have been suggested as a potential intervention for improving adherence to medications and health facility attendance. METHODS: An open-label, randomized, controlled trial to test the efficacy of automated SMS reminders in improving adherence to artemether-lumefantrine (AL) and post-treatment attendance in comparison with standard care was conducted at four health facilities in western Kenya. Children below five years of age with uncomplicated malaria were randomized to intervention (SMS reminders) or control groups...
January 25, 2017: Malaria Journal
Mitsuru Toda, Ian Njeru, Dejan Zurovac, Shikanga O-Tipo, David Kareko, Matilu Mwau, Kouichi Morita
We conducted a randomized, controlled trial to test the effectiveness of a text-messaging system used for notification of disease outbreaks in Kenya. Health facilities that used the system had more timely notifications than those that did not (19.2% vs. 2.6%), indicating that technology can enhance disease surveillance in resource-limited settings.
April 2016: Emerging Infectious Diseases
Dejan Zurovac, Jean-Olivier Guintran, Wesley Donald, Esau Naket, Josephine Malinga, George Taleo
BACKGROUND: Vanuatu, an archipelago country in Western Pacific harbouring low Plasmodium falciparum and Plasmodium vivax malaria transmission, has been implementing a malaria case management policy, recommending parasitological testing of patients with fever and anti-malarial treatment for test-positive only patients. A health facility survey to evaluate the health systems readiness to implement the policy and the quality of outpatient management for patients with fever was undertaken...
December 2, 2015: Malaria Journal
Sophie Githinji, Caroline Jones, Josephine Malinga, Robert W Snow, Ambrose Talisuna, Dejan Zurovac
BACKGROUND: Patients' low adherence to artemisinin-based combination therapy has been reported in areas of Kenya bordering the Lake Victoria region, where the burden of malaria remains high. A randomized controlled trial is underway to determine the efficacy of short message service (SMS) text reminders on adherence to artemether-lumefantrine and post-treatment review of children under the age of five. This paper reports on the iterative process of intervention and delivery system development...
August 19, 2015: Malaria Journal
Dejan Zurovac, Sophie Githinji, Dorothy Memusi, Samuel Kigen, Beatrice Machini, Alex Muturi, Gabriel Otieno, Robert W Snow, Andrew Nyandigisi
BACKGROUND: Monitoring implementation of the "test and treat" case-management policy for malaria is an important component of all malaria control programmes in Africa. Unfortunately, routine information systems are commonly deficient to provide necessary information. Using health facility surveys we monitored health systems readiness and malaria case-management practices prior to and following implementation of the 2010 "test and treat" policy in Kenya. METHODS/FINDINGS: Between 2010 and 2013 six national, cross-sectional, health facility surveys were undertaken...
2014: PloS One
Sophie Githinji, Samwel Kigen, Dorothy Memusi, Andrew Nyandigisi, Andrew Wamari, Alex Muturi, George Jagoe, René Ziegler, Robert W Snow, Dejan Zurovac
BACKGROUND: Effective surveillance systems are required to track malaria testing and treatment practices. A 26-week study "SMS for Life" was piloted in five rural districts of Kenya to examine whether SMS reported surveillance data could ensure real-time visibility of accurate data and their use by district managers to impact on malaria case-management. METHODS: Health workers from 87 public health facilities used their personal mobile phones to send a weekly structured SMS text message reporting the counts of four basic surveillance data elements to a web-based system accessed by district managers...
March 19, 2014: Malaria Journal
Grace W Irimu, Alexandra Greene, David Gathara, Harrison Kihara, Christopher Maina, Dorothy Mbori-Ngacha, Dejan Zurovac, Migiro Santau, Jim Todd, Mike English
BACKGROUND: Evidence-based standards for management of the seriously sick child have existed for decades, yet their translation in clinical practice is a challenge. The context and organization of institutions are known determinants of successful translation, however, research using adequate methodologies to explain the dynamic nature of these determinants in the quality-of-care improvement process is rarely performed. METHODS: We conducted mixed methods research in a tertiary hospital in a low-income country to explore the uptake of locally adapted paediatric guidelines...
2014: BMC Health Services Research
Grace W Irimu, Alexandra Greene, David Gathara, Harrison Kihara, Christopher Maina, Dorothy Mbori-Ngacha, Dejan Zurovac, Santau Migiro, Mike English
BACKGROUND: Implementation of World Health Organization case management guidelines for serious childhood illnesses remains a challenge in hospitals in low-income countries. Facilitators of and barriers to implementation of locally adapted clinical practice guidelines (CPGs) have not been explored. METHODS: This ethnographic study based on the theory of participatory action research (PAR) was conducted in Kenyatta National Hospital, Kenya's largest teaching hospital...
2014: BMC Health Services Research
Gabriel Otieno, Sophie Githinji, Caroline Jones, Robert W Snow, Ambrose Talisuna, Dejan Zurovac
BACKGROUND: Trials evaluating the impact of mobile phone text-messaging to support management of acute diseases, such as malaria, are urgently needed in Africa. There has been however a concern about the feasibility of interventions that rely on access to mobile phones among caregivers in rural areas. To assess the feasibility and inform development of an intervention to improve adherence to malaria medications and post-treatment review, mobile phone network, access, ownership and use among caregivers in western Kenya was assessed...
February 3, 2014: Malaria Journal
Dejan Zurovac, Gabriel Otieno, Samuel Kigen, Agneta M Mbithi, Alex Muturi, Robert W Snow, Andrew Nyandigisi
BACKGROUND: The rapid growth in mobile phone penetration and use of Short Message Service (SMS) has been seen as a potential solution to improve medical and public health practice in Africa. Several studies have shown effectiveness of SMS interventions to improve health workers' practices, patients' adherence to medications and availability of health facility commodities. To inform policy makers about the feasibility of facility-based SMS interventions, the coverage data on mobile phone ownership and SMS use among health workers and patients are needed...
2013: Globalization and Health
Sophie Githinji, Samwel Kigen, Dorothy Memusi, Andrew Nyandigisi, Agneta M Mbithi, Andrew Wamari, Alex N Muturi, George Jagoe, Jim Barrington, Robert W Snow, Dejan Zurovac
BACKGROUND: Health facility stock-outs of life saving malaria medicines are common across Africa. Innovative ways of addressing this problem are urgently required. We evaluated whether SMS based reporting of stocks of artemether-lumefantrine (AL) and rapid diagnostic tests (RDT) can result in reduction of stock-outs at peripheral facilities in Kenya. METHODS/FINDINGS: All 87 public health facilities in five Kenyan districts were included in a 26 week project. Weekly facility stock counts of four AL packs and RDTs were sent via structured incentivized SMS communication process from health workers' personal mobile phones to a web-based system accessed by district managers...
2013: PloS One
Dejan Zurovac, Bruce A Larson, Raymond K Sudoi, Robert W Snow
BACKGROUND: Simple interventions for improving health workers' adherence to malaria case-management guidelines are urgently required across Africa. A recent trial in Kenya showed that text-message reminders sent to health workers' mobile phones improved management of pediatric outpatients by 25 percentage points. In this paper we examine costs and cost-effectiveness of this intervention. METHODS/FINDINGS: We evaluate costs and cost-effectiveness in 2010 USD under three implementation scenarios: (1) as implemented under study conditions in study areas; (2) if the intervention was routinely implemented by the Ministry of Health (MoH) in the same areas; and (3) if the intervention was scaled up nationally...
2012: PloS One
Grace W Irimu, David Gathara, Dejan Zurovac, Harrison Kihara, Christopher Maina, Julius Mwangi, Dorothy Mbori-Ngacha, Jim Todd, Alexandra Greene, Mike English
BACKGROUND: Implementation of WHO case management guidelines for serious common childhood illnesses remains a challenge in hospitals in low-income countries. The impact of locally adapted clinical practice guidelines (CPGs) on the quality-of-care of patients in tertiary hospitals has rarely been evaluated. METHODS AND FINDINGS: We conducted, in Kenyatta National Hospital, an uncontrolled before and after study with an attempt to explore intervention dose-effect relationships, as CPGs were disseminated and training was progressively implemented...
2012: PloS One
Caroline O H Jones, Beatrice Wasunna, Raymond Sudoi, Sophie Githinji, Robert W Snow, Dejan Zurovac
This paper presents the results of a qualitative study to investigate the perceptions and experiences of health workers involved in a a cluster-randomized controlled trial of a novel intervention to improve health worker malaria case-management in 107 government health facilities in Kenya. The intervention involved sending text-messages about paediatric outpatient malaria case-management accompanied by "motivating" quotes to health workers' mobile phones. Ten malaria messages were developed reflecting recommendations from the Kenyan national guidelines...
2012: PloS One
Dejan Zurovac, Ambrose O Talisuna, Robert W Snow
No abstract text is available yet for this article.
February 2012: PLoS Medicine
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