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Mortality and morbidity from malaria were measured in children for a one-year period in a rural area of The Gambia 3-4 years after the introduction of a primary health care programme into some villages in the study area. Among children resident in primary health care villages who received treatment for febrile illnesses from a village health worker resident in their village there was no reduction in overall mortality or in morbidity from malaria compared with levels found in villages without a primary health care worker. However, among children aged 3-59 months who received malaria chemoprophylaxis from a village health worker in addition to treatment there was a 49% reduction in mortality and a 73% reduction in attacks of clinical malaria. The level of protection against malaria achieved by chemoprophylaxis given by village health workers 3-4 years after the chemoprophylaxis programme was started was as high as that obtained shortly after the introduction of the primary health care programme.


Journal article


Trans R Soc Trop Med Hyg

Publication Date





768 - 772


Africa, Africa South Of The Sahara, Age Distribution, Age Factors, Child Mortality--prevention and control, Delivery Of Health Care, Demographic Factors, Developing Countries, Diseases, Drugs--administraction and dosage, English Speaking Africa, Examinations And Diagnoses, Field Workers, Gambia, Health, Health Personnel, Health Services, Incidence, Laboratory Examinations And Diagnoses, Malaria, Measurement, Morbidity--prevention and control, Mortality, Parasitic Diseases, Population, Population Characteristics, Population Dynamics, Primary Health Care, Research Methodology, Rural Population, Treatment, Western Africa, Antimalarials, Child, Preschool, Community Health Workers, Dapsone, Drug Combinations, Female, Gambia, Humans, Malaria, Male, Patient Compliance, Primary Health Care, Pyrimethamine, Rural Population