ArticleMalaria journal2019
Intracluster correlation coefficients in the Greater Mekong Subregion for sample size calculations of cluster randomized malaria trials.
Article in Malaria journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01872702 (Targeted Chemo-elimination), which is not on this map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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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.
Targeted Chemo-elimination (TCE) to Eradicate Malaria in Areas of Suspected or Proven Artemisinin Resistance in Southeast Asia and South Asia
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Characterisation of between-cluster heterogeneity in malaria cluster randomised trials to inform future sample size calculations.Nature communications · 2025Pooled it
- Supervised versus unsupervised primaquine radical cure for the treatment of falciparum and vivax malaria in Papua, Indonesia: a cluster-randomised, controlled, open-label superiority trial.The Lancet. Infectious diseases · 2022Trial
- Trial
- Impact of Late-Rainy Season Indoor Residual Spraying on Holoendemic Malaria Transmission: A Cohort Study in Northern Zambia.The Journal of infectious diseases · 2025Article
- A multi-level analysis of prevalence and factors associated with caesarean section in Nigeria.PLOS global public health · 2023Article
- Multi-level predictors of sexual autonomy among married women in Nigeria.BMC women's health · 2022Article
- School and community driven dengue vector control and monitoring in Myanmar: Study protocol for a cluster randomized controlled trial.Wellcome open research · 2022Article
- Improved risk stratification by PET-based intratumor heterogeneity in children with high-risk neuroblastoma.Frontiers in oncology · 2022Article
- The use of islands and cluster-randomized trials to investigate vector control interventions: a case study on the Bijagós archipelago, Guinea-Bissau.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2021Review
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14 authors.
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Abstract
backgroundSample size calculations for cluster randomized trials are a recognized methodological challenge for malaria research in pre-elimination settings. Positively correlated responses from the participants in the same cluster are a key feature in the estimated sample size required for a cluster randomized trial. The degree of correlation is measured by the intracluster correlation coefficient (ICC) where a higher coefficient suggests a closer correlation hence less heterogeneity within clusters but more heterogeneity between clusters.
methodsData on uPCR-detected Plasmodium falciparum and Plasmodium vivax infections from a recent cluster randomized trial which aimed at interrupting malaria transmission through mass drug administrations were used to calculate the ICCs for prevalence and incidence of Plasmodium infections. The trial was conducted in four countries in the Greater Mekong Subregion, Laos, Myanmar, Vietnam and Cambodia. Exact and simulation approaches were used to estimate ICC values for both the prevalence and the incidence of parasitaemia. In addition, the latent variable approach to estimate ICCs for the prevalence was utilized.
resultsThe ICCs for prevalence ranged between 0.001 and 0.082 for all countries. The ICC from the combined 16 villages in the Greater Mekong Subregion were 0.26 and 0.21 for P. falciparum and P. vivax respectively. The ICCs for incidence of parasitaemia ranged between 0.002 and 0.075 for Myanmar, Cambodia and Vietnam. There were very high ICCs for incidence in the range of 0.701 to 0.806 in Laos during follow-up.
conclusionICC estimates can help researchers when designing malaria cluster randomized trials. A high variability in ICCs and hence sample size requirements between study sites was observed. Realistic sample size estimates for cluster randomized malaria trials in the Greater Mekong Subregion have to assume high between cluster heterogeneity and ICCs. This work focused on uPCR-detected infections; there remains a need to develop more ICC references for trials designed around prevalence and incidence of clinical outcomes. Adequately powered trials are critical to estimate the benefit of interventions to malaria in a reliable and reproducible fashion.
trial registrationClinicalTrials.govNCT01872702. Registered 7 June 2013. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT01872702.
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