Evidence map›Paper›PMID 27488692›Full record

Trial reportBMC public health2016

Effectiveness of educational outreach in infectious diseases management: a cluster randomized trial in Uganda.

Martin Kayitale Mbonye, Sarah M Burnett, Sarah Naikoba, Allan Ronald, Robert Colebunders, Jean-Pierre Van Geertruyden, Marcia R Weaver

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC public health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.0field-weighted citation impact, top 10% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 9 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

7 authors at 6 institutions in 4 countries.

Martin Kayitale MbonyeInfectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda. mbonyemarti@yahoo.com.
Sarah M BurnettGlobal Health Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Sarah NaikobaInfectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
Allan RonaldDepartment of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Robert ColebundersGlobal Health Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Jean-Pierre Van GeertruydenGlobal Health Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Marcia R WeaverDepartment of Global Health, University of Washington, International Training and Education Center for Health (I-TECH), Seattle, WA, USA.
University of Antwerp · BEAccordia Global Health Foundation · USInstituut voor Tropische Geneeskunde · BEMakerere University · UGUniversity of Manitoba · CAUniversity of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntegrated Infectious Diseases Capacity Building Evaluation (IDCAP) teams designed and implemented two health worker in-service training approaches: 1) an off-site classroom-based integrated management of infectious diseases (IMID) course with distance learning aspects, and 2) on-site support (OSS), an educational outreach intervention. We tested the effects of OSS on workload and 12 facility performance indicators for emergency triage assessment and treatment, HIV testing, and malaria and pneumonia case management among outpatients by two subgroups: 1) mid-level practitioners (MLP) who attended IMID training (IMID-MLP) and 2) health workers who did not (No-IMID).

methodsThirty-six health facilities participated in the IDCAP trial, with 18 randomly assigned to Arm A and 18 to Arm B. Two MLP in both arms received IMID. All providers at Arm A facilities received nine monthly OSS visits from April to December 2010 while Arm B did not. From November 2009 to December 2010, 777,667 outpatient visits occurred. We analyzed 669,580 (86.1 %) outpatient visits, where provider cadre was reported. Treatment was provided by 64 IMID-MLP and 1,515 No-IMID providers. The effect of OSS was measured by the difference in pre/post changes across arms after controlling for covariates (adjusted ratio of relative risks = a RRR).

resultsThe effect of OSS on patients-per-provider-per-day (workload) among IMID-MLP (aRRR = 1.21; p = 0.48) and No-IMID (aRRR = 0.90; p = 0.44) was not statistically significant. Among IMID-MLP, OSS was effective for three indicators: malaria cases receiving an appropriate antimalarial (aRRR = 1.26, 99 % CI = 1.02-1.56), patients with negative malaria test result prescribed an antimalarial (aRRR = 0.49, 99 % CI = 0.26-0.92), and patients with acid-fast bacilli smear negative result receiving empiric treatment for acute respiratory infection (aRRR = 2.04, 99 % CI = 1.06-3.94). Among No-IMID, OSS was effective for two indicators: emergency and priority patients admitted, detained or referred (aRRR = 2.12, 99 % CI = 1.05-4.28) and emergency patients receiving at least one appropriate treatment (aRRR = 1.98, 99 % CI = 1.21-3.24).

conclusionEffects of OSS on workload were not statistically significant. Significant OSS effects on facility performance across subgroups were heterogeneous. OSS supported MLP who diagnosed and treated patients to apply IMID knowledge. For other providers, OSS supported team work to manage emergency patients. This evidence on OSS effectiveness could inform interventions to improve health workers' capacity to deliver better quality infectious diseases care.

Indexed as

Capacity BuildingCommunicable Disease ControlInservice TrainingAnti-Bacterial AgentsAntimalarialsCase ManagementCommunicable DiseasesEducation, DistanceHealth FacilitiesHealth PersonnelHIV InfectionsHumansInfection ControlMalariaPneumoniaRespiratory Tract InfectionsAnti-Bacterial AgentsAntimalarialsClassroom trainingEducational outreachMid-level health providersUganda

Identifiers

PMID27488692
PMCPMC4972969
OpenAlexW2493461830

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.