Evidence map›Paper›PMID 38857947›Full record

Trial reportBMJ global health2024

An ancillary care policy in a vaccine trial conducted in a resource-constrained setting: evaluation and policy recommendations.

Gwen Lemey, Ynke Larivière, Bernard Isekah Osang'ir, Trésor Zola, Primo Kimbulu, Solange Milolo, Engbu Danoff, Yves Tchuma, Vivi Maketa, Patrick Mitashi and 4 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Trial
  2. 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

14 authors.

Gwen Lemey *Global Health Institute, University of Antwerp, Antwerpen, Belgium.ORCID http://orcid.org/0000-0002-2879-5330
Ynke Larivière *Global Health Institute, University of Antwerp, Antwerpen, Belgium ynke.lariviere@uantwerpen.be.ORCID http://orcid.org/0000-0002-5422-0194
Bernard Isekah Osang'irGlobal Health Institute, University of Antwerp, Antwerpen, Belgium.
Trésor ZolaGlobal Health Institute, University of Antwerp, Antwerpen, Belgium.
Primo KimbuluTropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the).
Solange MiloloTropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the).
Engbu DanoffTropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the).
Yves TchumaTropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the).
Vivi MaketaTropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the).
Patrick MitashiTropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the).
Raffaella RavinettoPublic Health, Institute of Tropical Medicine, Antwerp, Belgium.ORCID http://orcid.org/0000-0001-7765-2443
Pierre Van DammeCentre for the Evaluation of Vaccination, University of Antwerp, Antwerpen, Belgium.
Jean-Pierre Van GeertruydenGlobal Health Institute, University of Antwerp, Antwerpen, Belgium.
Hypolite Muhindo-MavokoTropical Medicine Department, University of Kinshasa, Kinshasa, Congo (the Democratic Republic of the).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionClear guidelines to implement ancillary care (AC) in clinical trials conducted in resource-constrained settings are lacking. Here, we evaluate an AC policy developed for a vaccine trial in the Democratic Republic of the Congo and formulate policy recommendations.

methodsTo evaluate the AC policy, we performed a longitudinal cohort study, nested in an open-label, single-centre, randomised Ebola vaccine trial conducted among healthcare personnel. Participants' demographic information, residence distance to the study site and details on the financial and/or medical support provided for any (serious) adverse events ((S)AE) were combined and analysed. To assess the feasibility of the AC policy, an expenditure analysis of the costs related to AC support outcomes was performed.

resultsEnrolment in this evaluation study started on 29 November 2021. The study lasted 11 months and included 655 participants from the Ebola vaccine trial. In total, 393 participants used the AC policy, mostly for AE management (703 AE and 94 SAE) via medication provided by the study pharmacy (75.3%). Men had a 35.2% (95% CI 4.0% to 56.6%) lower likelihood of reporting AE compared with women. Likewise, this was 32.3% lower (95% CI 5.8% to 51.4%) for facility-based compared with community-based healthcare providers. The daily AE reporting was 78.8% lower during the passive vs the active trial stage, and 97.4% lower during unscheduled vs scheduled visits (p<0.001). Participants living further than 10 km from the trial site more frequently reported the travel distance as a reason for not using the policy (p<0.04). In practice, only 1.1% of the operational trial budget was used for AC policy support.

conclusionThe trial design, study population and local health system impacted the use of the AC policy. Nonetheless, the AC policy implementation in this remote and resource-constrained setting was feasible, had negligible budgetary implications and contributed to participants' healthcare options and well-being.

Indexed as

Ebola VaccinesAdultDemocratic Republic of the CongoFemaleHealth PersonnelHealth PolicyHemorrhagic Fever, EbolaHumansLongitudinal StudiesMaleMiddle AgedEbola VaccinesCohort studyGlobal HealthHealth policyVaccines

Identifiers

PMID38857947
PMCPMC11168174

What OpenQuestion holds

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Registered trials

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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.