Evidence map›Paper›PMID 25739769›Full record

Trial reportBMJ (Clinical research ed.)2015

The impact of providing rapid diagnostic malaria tests on fever management in the private retail sector in Ghana: a cluster randomized trial.

Evelyn K Ansah, Solomon Narh-Bana, Harriet Affran-Bonful, Constance Bart-Plange, Bonnie Cundill, Margaret Gyapong, Christopher J M Whitty

2 registry-linked trialsOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 65 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 9 pooled it
13.2field-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.

NCT01907672 phase4completednot on this map

The Role of Rapid Diagnostic Tests for Malaria for Targeting of ACTs at Community Level: a Cluster Randomized Trial

TypeinterventionalSponsorGhana Health ServicesRan2011 to 2013Enrolled4,748ConditionsMalariaArmsRapid Diagnostic Test
NCT04301531 nacompletednot on this mapstarted 2020, after this paper: background citation

Determining the Impact of Scaling up Mass Testing, Treatment and Tracking on Malaria Prevalence Among Children in the Pakro Sub District of Ghana

TypeinterventionalSponsorNoguchi Memorial Institute for Medical ResearchRan2020 to 2023Enrolled5,861ConditionsMalaria Asymptomatic ParasitaemiaArmsMass testing using RDTs, Treatment for all cases confirmed positive malaria cases with ACTs, Determination of Hb, Household survey, Community-base management of malaria
3 · Its place in the literature

Who cites it

65 citing papers in PubMed, 9 syntheses or guidelines pooled it, 106 citations in OpenAlex.

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5 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

7 authors at 3 institutions in 2 countries.

Evelyn K AnsahResearch and Development Division, Ghana Health Service, PO Box MB-190, Accra, Ghana Ansahekdr@yahoo.co.uk.
Solomon Narh-BanaDodowa Health Research Center, Ghana Health Service.
Harriet Affran-BonfulDangme West District Health Directorate, Ghana Health Service.
Constance Bart-PlangeNational Malaria Control Programme, Ghana Health Service.
Bonnie CundillLondon School of Hygiene & Tropical Medicine, London, UK.
Margaret GyapongDodowa Health Research Center, Ghana Health Service.
Christopher J M WhittyLondon School of Hygiene & Tropical Medicine, London, UK.
Ghana Health Service · GHLondon School of Hygiene & Tropical Medicine · GBDodowa Health Research Centre · GH

Funding

Medical Research Council MR/K012126/1
6 · The paper itself

Abstract

objectiveTo examine the impact of providing rapid diagnostic tests for malaria on fever management in private drug retail shops where most poor rural people with fever present, with the aim of reducing current massive overdiagnosis and overtreatment of malaria.

designCluster randomized trial of 24 clusters of shops.

settingDangme West, a poor rural district of Ghana.

participantsShops and their clients, both adults and children.

interventionsProviding rapid diagnostic tests with realistic training.

main outcome measuresThe primary outcome was the proportion of clients testing negative for malaria by a double-read research blood slide who received an artemisinin combination therapy or other antimalarial. Secondary outcomes were use of antibiotics and antipyretics, and safety.

resultsOf 4603 clients, 3424 (74.4%) tested negative by double-read research slides. The proportion of slide-negative clients who received any antimalarial was 590/1854 (32%) in the intervention arm and 1378/1570 (88%) in the control arm (adjusted risk ratio 0.41 (95% CI 0.29 to 0.58), P<0.0001). Treatment was in high agreement with rapid diagnostic test result. Of those who were slide-positive, 690/787 (87.8%) in the intervention arm and 347/392 (88.5%) in the control arm received an artemisinin combination therapy (adjusted risk ratio 0.96 (0.84 to 1.09)). There was no evidence of antibiotics being substituted for antimalarials. Overall, 1954/2641 (74%) clients in the intervention arm and 539/1962 (27%) in the control arm received appropriate treatment (adjusted risk ratio 2.39 (1.69 to 3.39), P<0.0001). No safety concerns were identified.

conclusionsMost patients with fever in Africa present to the private sector. In this trial, providing rapid diagnostic tests for malaria in the private drug retail sector significantly reduced dispensing of antimalarials to patients without malaria, did not reduce prescribing of antimalarials to true malaria cases, and appeared safe. Rapid diagnostic tests should be considered for the informal private drug retail sector.Registration Clinicaltrials.gov NCT01907672.

Indexed as

Community Pharmacy ServicesPrivate SectorAdolescentAdultChildChild, PreschoolFemaleFeverGhanaHumansInappropriate PrescribingMalariaMalePharmaciesRural PopulationSingle-Blind Method

Identifiers

PMID25739769
PMCPMC4353311
OpenAlexW2089714452

What OpenQuestion holds

Textmetadata
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.