Active Parasite Detection 2011 Supplemental Enumerator and CHW Training 14 November, 2011

Centers for Disease Control-CDC Swiss Tropical Institute Johns Hopkins University The World Bank The Global Fund against AIDS, Tuberculosis and Malaria Liverpool School of Tropical Medicine MACRO International Malaria Consortium Malaria Control and Evaluation Partnership in Africa (MACEPA) – PATH Malaria in Pregnancy Consortium Secretariat MEASURE Evaluation WHO WHO-AFRO Tulane University UNICEF USAID/PMI

 1 questionnaire component ◦ Household questionnaire  Testing procedures

Household person listing all household members/usual residents Household Questionnaire Bednet Knowledge/Attitudes/Practices Household amenities / assets Malaria Prevention: Indoor Residual Spraying Malaria Prevention: Insecticide treated nets Possession Treatment status Use Malaria Testing/ Anemia Testing

Malaria and Anemia Testing Finger stick If Child 6-59 months old: Hemocue anaemia test Rapid Diagnostic Test Blood slide: thick and thin blood smear Dried blood spot If Needed: TREAT Unless women of reproductive age, then refer

 Global Positioning System (GPS) ◦ Mapping/Navigating to households  Personal Digital Assistants (PDAs) ◦ Guided Interview ◦ Household listing ◦ Questionnaire  Malaria parasite and anemia testing ◦ Hemocues ◦ Rapid Diagnostic Tests (RDTs) ◦ Malaria blood slides ◦ Filter papers/blood spots

Teams:  7 facilities for Gwembe and 3 for Sinazongwe Each team has: ◦ CHWs ◦ HWs ◦ 1team lead ◦ 1driver

Sampling Frame  ??? enumeration areas  700 households will be visited  ~1000 children  Average 2 days in each enumeration area

 Inclusion Criteria ◦ All residents of the Household  Exclusion Criteria ◦ Declined consent

Laboratory Collection  All people ◦ RDTs ◦ Slides  1 slide with a thick and thin smear ◦ Dried blood spot ◦ Anemia/Hemoglobin (Hemocue)

 Map of selected Areas

Contacting households Making Call backs

 Determine directions/route planning to village the night before you travel  Notify village leader of your arrival  Present letter from MOH  Explain the study  Arrange to have village guides  Identify enumeration area boundaries

 Ensure all PDAs, GPS, and lab equipment are charged and working properly  Ensure all team members know the village name/number  Review work assignments: ◦ Divide area among team members for mapping ◦ Divide households for interviews/call back appointments  Map all households within the EA boundaries  Coordinate a location to meetand method to reach supervisor if help is needed

 Because each household has been carefully selected, you must make every effort to conduct interviews with the households assigned to you  Absent households should be re-visited at least 2 times on at least 2 different days ◦ To gain consent ◦ To conduct HH interview ◦ To test children who may not be present  Attempts should be made at different times of the day

 What do you do when you arrive at the household?

 Wear your identification  Smile and introduce yourself  Verify that you are at the correct household  Identify eligible respondents  Obtain Informed Consent  Begin interview

What do you do if…?  An eligible respondent is not available?  A respondent refuses to be interviewed?  An interview is not completed?  A respondent is incapacitated?

 Because each household has been carefully selected, you must make every effort to conduct interviews with the households assigned to you  Sometimes a household member will not be available at the time you first visit.  Households with absent individuals should be re-visited at least 2 different times ◦ Call backs should be scheduled at different times of the day than the previous visit attempt

 Ensure any treatment schedules were performed appropriately.  Review the questionnaire to verify it is finished.  This review should be done before you leave the household so that you can be sure every appropriate question was asked and that all answers are clear and reasonable.  Clarify any errors with the respondent before leaving. Simply explain to the respondent that you made an error and ask the question again.  Thank the respondent for their time and participation.

 Before leaving  Notify village leader of your departure  Thank the village participants for their time and cooperation

 Look for Label  Ask for Original Packaging  Other features ◦ Observe: shape/size/color ◦ Touch/Feel: materials feel different  Hints: ◦ Source of net ◦ Age of net