ArticlePloS one2014
Increased access to care and appropriateness of treatment at private sector drug shops with integrated management of malaria, pneumonia and diarrhoea: a quasi-experimental study in Uganda.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 4 of them syntheses that pooled it.
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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
50 citing papers in PubMed, 4 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Pooled it
- Adding rapid diagnostic tests to community-based programmes for treating malaria.The Cochrane database of systematic reviews · 2022Pooled it
- Use of malaria RDTs in various health contexts across sub-Saharan Africa: a systematic review.BMC public health · 2017Pooled it
- Introducing malaria rapid diagnostic tests in private medicine retail outlets: A systematic literature review.PloS one · 2017Pooled it
- Community-Based Malaria Testing Reduces Polypharmacy in a Population-Based Survey of Febrile Illness in Western Kenya.International journal of public health · 2022Trial
- Subsidise the test, the treatment or both? Results of an individually randomised controlled trial of the management of suspected malaria fevers in the retail sector in western Kenya.BMJ global health · 2020Trial
- Strengthening referral of sick children from the private health sector and its impact on referral uptake in Uganda: a cluster randomized controlled trial protocol.BMC health services research · 2016Trial
- The impact of interventions to modify antibiotic use in children with suspected infections in ambulatory healthcare settings in LMICs: a systematic review.JAC-antimicrobial resistance · 2026Review
- Antibiotic stewardship and point-of-care testing for children in 25 low-income and lower-middle-income countries: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Regulatory gaps in over-the-counter antifungal access for vulvovaginal candidiasis in Uganda: A policy analysis framework.IJID regions · 2025Article
- How does the medicines retail sector ensure continued access to medicines during public health emergencies? Lessons from the COVID-19 pandemic in Uganda.Journal of pharmaceutical policy and practice · 2025Article
- Unmasking the complexities of healthcare access in low-resource settings: a health systems approach to obstetric and under-5 healthcare in rural settings of Eastern Uganda.Global health action · 2024Article
- Article
- Exploring different health care providers´ perceptions on the management of diarrhoea in cholera hotspots in the Democratic Republic of Congo: A qualitative content analysis.PLOS global public health · 2024Article
- Delivering maternal and child health interventions through the private sector in LMIC: a scoping review of strategies and effective approaches.BMJ public health · 2023Article
- A Comparative Analysis of Patient Profiles and Health Service Utilization between Patent Medicine Vendors and Community Pharmacists in Nigeria.Healthcare (Basel, Switzerland) · 2023Article
- Point-of-care testing in private pharmacy and drug retail settings: a narrative review.BMC infectious diseases · 2023Review
- Public Health Interventions Delivered by Pharmacy Professionals in Low- and Middle-Income Countries in Africa: A Systematic Scoping Review.Pharmacy (Basel, Switzerland) · 2023Article
- Assessment of integrated community case management of childhood illness (ICCM) practices by trained patent and proprietary medicine vendors (PPMVs) in Ebonyi and Kaduna states, Nigeria.BMC health services research · 2023Article
- Private sector antimalarial sales a decade after "test and treat": A cross-sectional study of drug shop clients in rural Uganda.Frontiers in public health · 2023Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDrug shops are a major source of care for children in low income countries but they provide sub-standard care. We assessed the feasibility and effect on quality of care of introducing diagnostics and pre-packaged paediatric-dosage drugs for malaria, pneumonia and diarrhoea at drug shops in Uganda.
methodsWe adopted and implemented the integrated community case management (iCCM) intervention within registered drug shops. Attendants were trained to perform malaria rapid diagnostic tests (RDTs) in each fever case and count respiratory rate in each case of cough with fast/difficult breathing, before dispensing recommended treatment. Using a quasi-experimental design in one intervention and one non-intervention district, we conducted before and after exit interviews for drug seller practices and household surveys for treatment-seeking practices in May-June 2011 and May-June 2012. Survey adjusted generalized linear models and difference-in-difference analysis was used.
results3759 (1604 before/2155 after) household interviews and 943 (163 before/780 after) exit interviews were conducted with caretakers of children under-5. At baseline, no child at a drug shop received any diagnostic testing before treatment in both districts. After the intervention, while no child in the non-intervention district received a diagnostic test, 87.7% (95% CI 79.0-96.4) of children with fever at the intervention district drug shops had a parasitological diagnosis of malaria, prior to treatment. The prevalence ratios of the effect of the intervention on treatment of cough and fast breathing with amoxicillin and diarrhoea with ORS/zinc at the drug shop were 2.8 (2.0-3.9), and 12.8 (4.2-38.6) respectively. From the household survey, the prevalence ratio of the intervention effect on use of RDTs was 3.2 (1.9-5.4); Artemisinin Combination Therapy for malaria was 0.74 (0.65-0.84), and ORS/zinc for diarrhoea was 2.3 (1.2-4.7).
conclusioniCCM can be utilized to improve access and appropriateness of care for children at drug shops.
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Registered trials
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