Evidence map›Paper›PMID 28122542›Full record

Trial reportBMC pediatrics2017

Universal versus conditional three-day follow up visit for children with uncomplicated fever at the community level: design of a cluster-randomized, community-based, non-inferiority trial in Tanganyika, Democratic Republic of Congo.

Elburg van Boetzelaer, Lara S Ho, Julie R Gutman, Laura C Steinhardt, Alison Wittcoff, Yolanda Barbera, Pascal Ngoy, Steven A Harvey, Luke C Mullany

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

Trial report in BMC pediatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02595827 (Universal Versus Conditional Follow Up for Children With Unclassified Fever at the Community Level), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.0field-weighted citation impact, top 13% 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.

NCT02595827 phase3completednot on this map

Universal Versus Conditional Follow Up for Children With Unclassified Fever at the Community Level: A Cluster-Randomized, Community-based, Non-Inferiority Trial in Kalemie, Democratic Republic of Congo (DRC)

TypeinterventionalSponsorJohns Hopkins Bloomberg School of Public HealthRan2015 to 2016Enrolled4,451ConditionsFeverArmsConditional Advice
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
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

9 authors at 4 institutions in 2 countries.

Elburg van BoetzelaerInternational Rescue Committee, Kalemie, Democratic Republic of Congo.
Lara S HoInternational Rescue Committee, New York, USA.
Julie R GutmanMalaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Laura C SteinhardtMalaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Alison WittcoffInternational Rescue Committee, Kalemie, Democratic Republic of Congo.
Yolanda BarberaInternational Rescue Committee, New York, USA.
Pascal NgoyInternational Rescue Committee, Kalemie, Democratic Republic of Congo.
Steven A HarveyDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, W5009C, Baltimore, MD, 21205, USA.
Luke C MullanyDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, W5009C, Baltimore, MD, 21205, USA. lcm@jhu.edu.
International Rescue Committee · ETCenters for Disease Control and Prevention · USInternational Rescue Committee · USJohns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe current recommendation within integrated Community Case Management guidelines that all children presenting with uncomplicated fever and no danger signs be followed up after three days may not be necessary. Such fevers often resolve rapidly (usually within 48-96 h), and previous studies suggest that expectant home care for uncomplicated fever can be safely recommended. We aim to determine the non-inferiority of a conditional versus a universal follow-up visit for these children.

methodsWe are conducting a cluster-randomized, community-based, non-inferiority trial enrolling ~4300 children (ages 2-59 months) presenting to community health workers (CHWs) with uncomplicated fever in Tanganyika Province, Democratic Republic of the Congo. Clusters (n = 28) of CHWs are randomized to advise caretakers of such children to either 1) return for a follow-up visit on Day 3 following the initial consultation (Day 1), regardless of illness resolution (as per current guidelines) or 2) return for a follow-up visit on Day 3 only if the child's signs have not resolved. Enrolled children are followed up at Day 7 for a repeat assessment and recording of the primary outcome of the study, "failure", which is defined as having fever, diarrhea, pneumonia or decline of health status (e.g. hospitalization, presenting danger signs, or death). DISCUSSION: The results of this trial will be interpreted in conjunction with a similarly designed trial currently ongoing in Ethiopia. If a follow-up visit conditional on continued illness is shown to be non-inferior to current guidelines stipulating universal follow-up, appropriate updating of such guidelines could reduce time and human resource pressures on both providers and caregivers throughout communities of sub-Saharan Africa and South Asia.

trial registrationThis trial was registered at ClinicalTrials.gov ( NCT02595827 ) on November 2nd, 2015.

Indexed as

AftercareChild, PreschoolClinical ProtocolsCommunity Health WorkersDemocratic Republic of the CongoFemaleFeverFollow-Up StudiesHumansInfantMaleTreatment OutcomeWatchful WaitingCluster randomized trialCommunity health workerDemocratic Republic of the CongoIntegrated community case managementNon-inferiorityPediatricsUncomplicated fever

Identifiers

PMID28122542
PMCPMC5267426
OpenAlexW2581867121

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.