Evidence map›Paper›PMID 29661635›Full record

Trial reportThe Lancet. Global health2018

Assessment of community-level effects of intermittent preventive treatment for malaria in schoolchildren in Jinja, Uganda (START-IPT trial): a cluster-randomised trial.

Sarah G Staedke, Catherine Maiteki-Sebuguzi, Andrea M Rehman, Simon P Kigozi, Samuel Gonahasa, Jaffer Okiring, Steve W Lindsay, Moses R Kamya, Clare I R Chandler, Grant Dorsey and 1 more

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

Trial report in The Lancet. Global health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02009215 ('SCHOOL-BASED TREATMENT WITH ACT TO REDUCE TRANSMISSION'), which is not on this map. Cited by 39 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 3 pooled it
5.3field-weighted citation impact, top 4% 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.

NCT02009215 phase4completednot on this map

'SCHOOL-BASED TREATMENT WITH ACT TO REDUCE TRANSMISSION' (START-IPT): Evaluation of the Community Impact of Intermittent Preventive Treatment for Malaria in Ugandan Children: a Cluster Randomised Trial

TypeinterventionalSponsorLondon School of Hygiene and Tropical MedicineRan2014 to 2015Enrolled10,746ConditionsMalariaArmsDihydroartemisinin-piperaquine (DP)
3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 3 syntheses or guidelines pooled it, 61 citations in OpenAlex.

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  9. Dihydroartemisinin-Piperaquine Chemoprevention and Malaria Incidence After Severe Flooding: Evaluation of a Pragmatic Intervention in Rural Uganda.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 3 countries.

Sarah G StaedkeDepartment of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK. Electronic address: sarah.staedke@lshtm.ac.uk.
Catherine Maiteki-SebuguziInfectious Diseases Research Collaboration, Kampala, Uganda.
Andrea M RehmanDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Simon P KigoziInfectious Diseases Research Collaboration, Kampala, Uganda.
Samuel GonahasaInfectious Diseases Research Collaboration, Kampala, Uganda.
Jaffer OkiringInfectious Diseases Research Collaboration, Kampala, Uganda.
Steve W LindsayDepartment of Biosciences, Durham University, Durham, UK.
Moses R KamyaSchool of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Clare I R ChandlerDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Grant DorseyDepartment of Medicine, University of California, San Francisco, CA, USA.
Chris DrakeleyDepartment of Infection and Immunity, London School of Hygiene and Tropical Medicine, London, UK.
Infectious Diseases Research Collaboration · UGLondon School of Hygiene & Tropical Medicine · GBDurham University · GBMakerere University · UGUniversity of California, San Francisco · US

Funding

Medical Research Council MR/K00736X/1Medical Research Council MR/K012126/1Wellcome Trust
6 · The paper itself

Abstract

backgroundIntermittent preventive treatment (IPT) is a well established malaria control intervention. Evidence that delivering IPT to schoolchildren could provide community-level benefits is limited. We did a cluster-randomised controlled trial to assess the effect of IPT of primary schoolchildren with dihydroartemisinin-piperaquine (DP) on indicators of malaria transmission in the community, in Jinja, Uganda.

methodsWe included 84 clusters, each comprising one primary school and the 100 closest available households. The clusters were randomly assigned 1:1 to receive IPT with DP or standard care (control) by restricted randomisation to ensure balance by geography and school type. Children in intervention schools received IPT monthly for up to six rounds (June to December, 2014). We did cross-sectional community surveys in randomly selected households at baseline and in January to April, 2015, during which we measured participants' temperatures and obtained finger-prick blood smears for measurement of parasite prevalence by microscopy. We also did entomological surveys 1 night per month in households from 20 randomly selected IPT and 20 control clusters. The primary trial outcome was parasite prevalence in the final community survey. The primary entomological survey outcome was the annual entomological inoculation rate (aEIR) from July, 2014, to April, 2015. This trial is registered at ClinicalTrials.gov, number NCT02009215.

findingsAmong 23 280 students registered in the 42 intervention schools, 10 079 (43%) aged 5-20 years were enrolled and received at least one dose of DP. 9286 (92%) of 10 079 received at least one full course of DP (three doses). Community-level parasite prevalence was lower in the intervention clusters than in the control clusters (19% vs 23%, adjusted risk ratio 0·85, 95% CI 0·73-1·00, p=0·05). The aEIR was lower in the intervention group than in the control group, but not significantly so (10·1 vs 15·2 infective bites per person, adjusted incidence rate ratio 0·80, 95% CI 0·36-1·80, p=0·59).

interpretationIPT of schoolchildren with DP might have a positive effect on community-level malaria indicators and be operationally feasible. Studies with greater IPT coverage are needed.

fundingUK Medical Research Council, UK Department for International Development, and Wellcome Trust.

Indexed as

School Health ServicesAdolescentAntimalarialsArtemisininsChildChild, PreschoolCluster AnalysisCross-Sectional StudiesDrug Administration ScheduleDrug CombinationsFemaleHealth SurveysHumansMalariaMalePiperazinesAntimalarialsArtemisininsartenimolDrug CombinationspiperaquinePiperazinesQuinolines

Identifiers

PMID29661635
PMCPMC5952991
OpenAlexW2797566092

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.