Evidence map›Paper›PMID 27055275›Full record

Trial reportPloS one2016

Effect of Test-Based versus Presumptive Treatment of Malaria in Under-Five Children in Rural Ghana--A Cluster-Randomised Trial.

Frank Baiden, Jane Bruce, Jayne Webster, Mathilda Tivura, Rupert Delmini, Seeba Amengo-Etego, Seth Owusu-Agyei, Daniel Chandramohan

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

Trial report in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00832754 (Effects of Restricting the Use of AS-AQ Combination Therapy to Malaria Cases Confirmed by a Dipstick Test), which is not on this map. Cited by 10 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 4 pooled it
1.2field-weighted citation impact, top 17% 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.

NCT00832754 phase4completednot on this map

Effects of Restricting the Use of AS-AQ Combination Therapy to Malaria Cases Confirmed by a Dipstick Test: A Cluster Randomised Control Trial

TypeinterventionalSponsorKintampo Health Research Centre, GhanaRan2009 to 2012Enrolled3,063ConditionsMalariaArmsRDT, Clinical Judgement as basis for treatment of malaria with ACT
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 4 syntheses or guidelines pooled it, 14 citations in OpenAlex.

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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

8 authors at 3 institutions in 3 countries.

Frank BaidenEpidemiology Unit, Ensign College of Public Health, Kpong, Eastern Region, Ghana.
Jane BruceDepartment of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom.
Jayne WebsterDepartment of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom.
Mathilda TivuraACT Trial Team, Kintampo Health Research Centre, Kintampo, Brong Ahafo Region, Ghana.
Rupert DelminiACT Trial Team, Kintampo Health Research Centre, Kintampo, Brong Ahafo Region, Ghana.
Seeba Amengo-EtegoACT Trial Team, Kintampo Health Research Centre, Kintampo, Brong Ahafo Region, Ghana.
Seth Owusu-AgyeiDepartment of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom.
Daniel ChandramohanDepartment of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom.
Kintampo Health Research Centre · GHUniversity of London · GBLDS Business College · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMalaria-endemic countries in sub-Saharan Africa are shifting from the presumptive approach that is based on clinical judgement (CJ) to the test-based approach that is based on confirmation through test with rapid diagnostic tests (RDT). It has been suggested that the loss of the prophylactic effect of presumptive-administered ACT in children who do not have malaria will result in increase in their risk of malaria and anaemia. METHODS AND

findingsWe undertook a cluster-randomized controlled trial to compare the effects of the presumptive approach using clinical judgment (CJ-arm) and the test-based approach using RDTs (RDT-arm in a high-transmission setting in Ghana. A total of 3046 eligible children (1527 in the RDT arm and 1519 in the CJ- arm) living around 32 health centres were enrolled. Nearly half were female (48.7%) and 47.8% were below the age of 12 months as at enrolment. Over 24-months, the incidence of all episodes of malaria following the first febrile illness was 0.64 (95% CI 0.49-0.82) and 0.76 (0.63-0.93) per child per year in the RDT and CJ arms respectively (adjusted rate ratio 1.13 (0.82-1.55). After the first episode of febrile illness, the incidence of severe anaemia was the same in both arms (0.11 per child per year) and that of moderate anaemia was 0.16 (0.13-0.21) vs. 0.17 (0.14-0.21) per child year respectively. The incidence of severe febrile illness was 0.15 (0.09, 0.24) in the RDT arm compared to 0.17 (0.11, 0.28) per child per year respectively. The proportion of fever cases receiving ACT was lower in the RDT arm (72% vs 81%; p = 0.02).

conclusionThe test-based approach to the management of malaria did not increase the incidence of malaria or anaemia among under-five children in this setting.

trial registrationClinicalTrials.gov NCT00832754.

Indexed as

AnemiaChild, PreschoolFemaleFollow-Up StudiesGhanaHumansIncidenceInfantMalariaMale

Identifiers

PMID27055275
PMCPMC4824463
OpenAlexW2331866171

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.