Trial reportThe American journal of tropical medicine and hygiene2012
Impact of community management of fever (using antimalarials with or without antibiotics) on childhood mortality: a cluster-randomized controlled trial in Ghana.
Trial report in The American journal of tropical medicine and hygiene, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Integrated community case management of childhood illness in low- and middle-income countries.The Cochrane database of systematic reviews · 2021Pooled it
- Use of malaria RDTs in various health contexts across sub-Saharan Africa: a systematic review.BMC public health · 2017Pooled it
- Community health workers and stand-alone or integrated case management of malaria: a systematic literature review.The American journal of tropical medicine and hygiene · 2014Pooled it
- Integrated community case management of malaria and pneumonia increases prompt and appropriate treatment for pneumonia symptoms in children under five years in Eastern Uganda.Malaria journal · 2013Trial
- The 'Health-2-Go' programme's impact on all-cause mortality and clinic utilisation for children 5 and under: a retrospective cohort analysis of an iCCM intervention in Ghana's Barekese Subdistrict.BMJ global health · 2025Article
- The impact of home-based management of malaria on clinical outcomes in sub-Saharan African populations: a systematic review and meta-analysis.Tropical medicine and health · 2024Article
- Policy Challenges Facing the Scale Up of Integrated Community Case Management (iCCM) in Uganda.International journal of health policy and management · 2022Article
- Assessing Determinants of Programmatic Performance of Community Management of Malaria, Pneumonia, and Diarrhea in Children in Africa: Protocol and Data Collection for a Mixed Methods Evaluation of Integrated Community Case Management.JMIR research protocols · 2022Article
- Admissible multiarm stepped-wedge cluster randomized trial designs.Statistics in medicine · 2019Article
- Article
- Effectiveness of two community-based strategies on disease knowledge and health behaviour regarding malaria, diarrhoea and pneumonia in Ghana.BMC public health · 2017Article
- Integrated community case management in a peri-urban setting: a qualitative evaluation in Wakiso District, Uganda.BMC health services research · 2017Article
- Article
- Assessing the impact of health research on health policies: a study of the Dodowa Health Research Centre, Ghana.BMC health services research · 2017Article
- Proposed variations of the stepped-wedge design can be used to accommodate multiple interventions.Journal of clinical epidemiology · 2017Article
- Solid medical waste: a cross sectional study of household disposal practices and reported harm in Southern Ghana.BMC public health · 2017Article
- Where there is no doctor: can volunteer community health workers in rural Uganda provide integrated community case management?African health sciences · 2017Article
- Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach.BMC public health · 2017Article
- Observational
- Stepped wedge cluster randomised trials: a review of the statistical methodology used and available.BMC medical research methodology · 2016Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Malaria and pneumonia are leading causes of childhood mortality. Home Management of fever as Malaria (HMM) enables presumptive treatment with antimalarial drugs but excludes pneumonia. We aimed to evaluate the impact of adding an antibiotic, amoxicillin (AMX) to an antimalarial, artesunate amodiaquine (AAQ + AMX) for treating fever among children 2-59 months of age within the HMM strategy on all-cause mortality. In a stepped-wedge cluster-randomized, open trial, children 2-59 months of age with fever treated with AAQ or AAQ + AMX within HMM were compared with standard care. Mortality reduced significantly by 30% (rate ratio [RR] = 0.70, 95% confidence interval [CI] = 0.53-0.92, P = 0.011) in AAQ clusters and by 44% (RR = 0.56, 95% CI = 0.41-0.76, P = 0.011) in AAQ + AMX clusters compared with control clusters. The 21% mortality reduction between AAQ and AAQ + AMX (RR = 0.79, 95% CI = 0.56-1.12, P = 0.195) was however not statistically significant. Community fever management with antimalarials significantly reduces under-five mortality. Given the lower mortality trend, adding an antibiotic is more beneficial.
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