Evidence map›Paper›PMID 35738650›Full record

Trial reportBMJ open2022

Cost and cost effectiveness of reactive case detection (RACD), reactive focal mass drug administration (rfMDA) and reactive focal vector control (RAVC) to reduce malaria in the low endemic setting of Namibia: an analysis alongside a 2×2 factorial design cluster randomised controlled trial.

Henry Ntuku, Cara Smith-Gueye, Valerie Scott, Joseph Njau, Brooke Whittemore, Brittany Zelman, Munyaradzi Tambo, Lisa M Prach, Lindsey Wu, Leah Schrubbe and 10 more

2 registry-linked trialsOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 9 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 3 pooled it
3.0field-weighted citation impact, top 9% 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.

NCT02610400 phase3completednot on this map

Targeted Parasite Elimination in the Human and Mosquito to Reduce Malaria Transmission: A Cluster Randomised Controlled Factorial Design Trial of Reactive Focal Drug Administration (rfMDA) Versus Reactive Case Detection (RACD), With and Without Reactive Vector Control (RAVC), From the Low Endemic Setting of Namibia

TypeinterventionalSponsorUniversity of California, San FranciscoRan2016 to 2017Enrolled9,845ConditionsMalariaArmsRACD, RAVC, rfMDA
NCT05690841 phase3recruitingnot on this mapstarted 2024, after this paper: background citation

FocaL Mass Drug Administration for Vivax Malaria Elimination (FLAME): a Pragmatic Cluster Randomized Controlled Trial in Peru

TypeinterventionalSponsorUniversity of California, San FranciscoRan2024 to 2027Enrolled7,530ConditionsPlasmodium Vivax Malaria, MalariaArmsFocal Mass Drug Administration (fMDA)
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 3 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Pooled it
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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

20 authors at 6 institutions in 4 countries.

Henry NtukuMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA hntuku@path.org.ORCID 0000-0001-7218-2710
Cara Smith-GueyeMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA.
Valerie ScottMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA.
Joseph NjauJoDon Consulting Group LLC, Atlanta, Georgia, USA.
Brooke WhittemoreDepartment of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Brittany ZelmanMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA.
Munyaradzi TamboMultidisciplinary Research Centre, University of Namibia, Windhoek, Namibia.
Lisa M PrachMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA.
Lindsey WuDepartment of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK.
Leah SchrubbeMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA.
Mi-Suk Kang DufourDivision of Prevention Science, University of California San Francisco, San Francisco, California, USA.
Agnes MwilimaMinistry of Health and Social Services, Zambezi Region, Katima Mulilo, Namibia.
Petrina UusikuMinistry of Health and Social Services, Windhoek, Namibia.
Hugh SturrockMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA.
Adam BennettMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA.
Jennifer SmithMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA.
Immo KleinschmidtFaculty of Health Sciences, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa.
Davis MumbengegwiMultidisciplinary Research Centre, University of Namibia, Windhoek, Namibia.
Roly GoslingMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA.
Michelle HsiangMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA.
University of California, San Francisco · USMinistry of Health and Social Services · NAUniversity of Namibia · NALondon School of Hygiene & Tropical Medicine · GBThe University of Texas Southwestern Medical Center · USUniversity of the Witwatersrand · ZA

Funding

Genetic and social network analysis to target interventions for malaria eliminationK01AI153555 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SMITH, JENNIFER LINNEA · 2020 to 2024
$725k
Medical Research Council MR/R010161/1NIAID NIH HHS K01 AI153555
6 · The paper itself

Abstract

objectivesTo estimate the cost and cost effectiveness of reactive case detection (RACD), reactive focal mass drug administration (rfMDA) and reactive focal vector control (RAVC) to reduce malaria in a low endemic setting.

settingThe study was part of a 2×2 factorial design cluster randomised controlled trial within the catchment area of 11 primary health facilities in Zambezi, Namibia.

participantsCost and outcome data were collected from the trial, which included 8948 community members that received interventions due to their residence within 500 m of malaria index cases. OUTCOME MEASURES: The primary outcome was incremental cost effectiveness ratio (ICER) per in incident case averted. ICER per prevalent case and per disability-adjusted life years (DALY) averted were secondary outcomes, as were per unit interventions costs and personnel time. Outcomes were compared as: (1) rfMDA versus RACD, (2) RAVC versus no RAVC and (3) rfMDA+RAVC versus RACD only.

resultsrfMDA cost 1.1× more than RACD, and RAVC cost 1.7× more than no RAVC. Relative to RACD only, the cost of rfMDA+RAVC was double ($3082 vs $1553 per event). The ICERs for rfMDA versus RACD, RAVC versus no RAVC and rfMDA+RAVC versus RACD only were $114, $1472 and $842, per incident case averted, respectively. Using prevalent infections and DALYs as outcomes, trends were similar. The median personnel time to implement rfMDA was 20% lower than for RACD (30 vs 38 min per person). The median personnel time for RAVC was 34 min per structure sprayed.

conclusionImplemented alone or in combination, rfMDA and RAVC were cost effective in reducing malaria incidence and prevalence despite higher implementation costs in the intervention compared with control arms. Compared with RACD, rfMDA was time saving. Cost and time requirements for the combined intervention could be decreased by implementing rfMDA and RAVC simultaneously by a single team. TRIAL REGISTRATION NUMBER: NCT02610400; Post-results.

Indexed as

MalariaMass Drug AdministrationCost-Benefit AnalysisHumansNamibiaResearch DesignEPIDEMIOLOGYHEALTH ECONOMICSHealth policyPublic health

Identifiers

PMID35738650
PMCPMC9226870
OpenAlexW4283458887

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.