Evidence map›Paper›PMID 21750697›Full record

Trial reportPloS one2011

Malaria rapid testing by community health workers is effective and safe for targeting malaria treatment: randomised cross-over trial in Tanzania.

Marycelina Mubi, Annika Janson, Marian Warsame, Andreas Mårtensson, Karin Källander, Max G Petzold, Billy Ngasala, Gloria Maganga, Lars L Gustafsson, Amos Massele and 3 more

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00301015 (Rapid Diagnostic Testing and Artemisinin-Based Combination Therapy for Uncomplicated Malaria by Community Health Workers), which is not on this map. Cited by 93 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
93citing papers in PubMed, 13 pooled it
13.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00301015 phase4completednot on this map

Rapid Diagnostic Testing and Artemisinin-Based Combination Therapy for Uncomplicated Malaria by Community Health Workers

TypeinterventionalSponsorKarolinska University HospitalRan2006 to 2006Enrolled3,005ConditionsUncomplicated Plasmodium Falciparum MalariaArmsRapid diagnostic test for malaria
3 · Its place in the literature

Who cites it

93 citing papers in PubMed, 13 syntheses or guidelines pooled it, 156 citations in OpenAlex.

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  13. Home- or community-based programmes for treating malaria.The Cochrane database of systematic reviews · 2013
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33 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 2 countries.

Marycelina MubiDepartment of Parasitology, School of Public Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Annika Janson
Marian Warsame
Andreas Mårtensson
Karin Källander
Max G Petzold
Billy Ngasala
Gloria Maganga
Lars L Gustafsson
Amos Massele
Göran Tomson
Zul Premji
Anders Björkman
Karolinska Institutet · SEMuhimbili University of Health and Allied Sciences · TZKarolinska University Hospital · SENordic School of Public Health · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly diagnosis and prompt, effective treatment of uncomplicated malaria is critical to prevent severe disease, death and malaria transmission. We assessed the impact of rapid malaria diagnostic tests (RDTs) by community health workers (CHWs) on provision of artemisinin-based combination therapy (ACT) and health outcome in fever patients. METHODOLOGY/PRINCIPAL

findingsTwenty-two CHWs from five villages in Kibaha District, a high-malaria transmission area in Coast Region, Tanzania, were trained to manage uncomplicated malaria using RDT aided diagnosis or clinical diagnosis (CD) only. Each CHW was randomly assigned to use either RDT or CD the first week and thereafter alternating weekly. Primary outcome was provision of ACT and main secondary outcomes were referral rates and health status by days 3 and 7. The CHWs enrolled 2930 fever patients during five months of whom 1988 (67.8%) presented within 24 hours of fever onset. ACT was provided to 775 of 1457 (53.2%) patients during RDT weeks and to 1422 of 1473 (96.5%) patients during CD weeks (Odds Ratio (OR) 0.039, 95% CI 0.029-0.053). The CHWs adhered to the RDT results in 1411 of 1457 (96.8%, 95% CI 95.8-97.6) patients. More patients were referred on inclusion day during RDT weeks (10.0%) compared to CD weeks (1.6%). Referral during days 1-7 and perceived non-recovery on days 3 and 7 were also more common after RDT aided diagnosis. However, no fatal or severe malaria occurred among 682 patients in the RDT group who were not treated with ACT, supporting the safety of withholding ACT to RDT negative patients. CONCLUSIONS/SIGNIFICANCE: RDTs in the hands of CHWs may safely improve early and well-targeted ACT treatment in malaria patients at community level in Africa.

trial registrationClinicalTrials.gov NCT00301015.

Indexed as

AdolescentAdultAgedAntimalarialsArtemisininsChildChild, PreschoolCommunity Health ServicesCommunity Health WorkersCross-Over StudiesDiagnostic Tests, RoutineDrug Therapy, CombinationFemaleFeverHealth PersonnelHumansAntimalarialsartemisininArtemisinins

Identifiers

PMID21750697
PMCPMC3130036
OpenAlexW2091649381

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.