Evidence map›Paper›PMID 40412814›Full record

Trial reportBMJ global health2025

Impact of proactive malaria community case management (proCCM) on parasite prevalence and incidence from 2021 to 2023: a randomised controlled trial in Chadiza District, Eastern Province, Zambia.

Marie-Reine I Rutagwera, Ellen L Ferriss, Bupe M Kabamba, Travis Porter, Chabu C Kangale, Sarah Gallalee, Melody Simataa, John M Miller, Caroline Phiri-Chibawe, Maximillian Musunse and 10 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04839900 (A Cluster Randomized Controlled Trial of Pro-active Community Case Management for Malaria in Chadiza District, Eastern Province, Zambia), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

NCT04839900 nacompletednot on this map

A Cluster Randomized Controlled Trial of Pro-active Community Case Management for Malaria in Chadiza District, Eastern Province, Zambia

TypeinterventionalSponsorPATHRan2021 to 2023Enrolled10,890ConditionsMalaria, Falciparum, MalariaArmsProactive iCCM
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

20 authors.

Marie-Reine I Rutagwera *PATH, Lusaka, Zambia.
Ellen L Ferriss *PATH, Seattle, Washington, USA eferriss@path.org.ORCID http://orcid.org/0000-0003-4510-800X
Bupe M KabambaPATH, Lusaka, Zambia.ORCID http://orcid.org/0009-0009-1206-7660
Travis PorterPATH, Seattle, Washington, USA.
Chabu C KangalePATH, Lusaka, Zambia.
Sarah GallaleeUniversity of California San Francisco, UCSF Institute for Global Health Sciences, San Francisco, California, USA.
Melody SimataaPATH, Lusaka, Zambia.
John M MillerPATH, Lusaka, Zambia.
Caroline Phiri-ChibawePATH, Lusaka, Zambia.
Maximillian MusunsePATH, Lusaka, Zambia.
Patrick NyendwaPATH, Lusaka, Zambia.
Viennah KapendaPATH, Lusaka, Zambia.
Paul PsychasUS President's Malaria Initiative, Centers for Disease Control and Prevention, Lusaka, Zambia.
Julie R GutmanMalaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID http://orcid.org/0000-0001-6769-7322
Moonga HawelaNational Malaria Elimination Centre, Zambia Ministry of Health, Lusaka, Zambia.
Ignatius BandaNational Malaria Elimination Centre, Zambia Ministry of Health, Lusaka, Zambia.
Sampa Chitambala-OtionoNational Malaria Elimination Centre, Zambia Ministry of Health, Lusaka, Zambia.
Adam BennettPATH, Seattle, Washington, USA.
Busiku HamainzaNational Malaria Elimination Centre, Zambia Ministry of Health, Lusaka, Zambia.
Julie I ThwingMalaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Ensuring prompt and effective case management of malaria remains an ongoing challenge in Zambia, where care is not sought for roughly 40% of febrile children under 5 years of age. To expand access, the Ministry of Health has scaled up routine malaria community case management (mCCM) for all ages over the past decade. As of 2018, nearly a quarter of children who received antimalarials obtained them from a community health worker (CHW), but gaps in treatment seeking remain. Proactive community case management (proCCM), under which CHWs regularly visit households to screen, test and treat individuals for malaria, aims to improve timely case management, avert severe disease and potentially reduce transmission. To evaluate the impact of weekly proCCM on malaria parasite prevalence and incidence in the context of strong routine community case management, we conducted a two-arm cluster-randomised controlled trial, comparing proCCM plus routine passive care to routine passive care only in Chadiza District, Eastern Province, Zambia, between April 2021 and May 2023. Baseline and endline surveys were conducted during peak transmission season to ascertain parasite prevalence, while facility, routine mCCM and proCCM incidence data were collected through routine surveillance systems and weekly household visits, respectively. In the control arm, malaria prevalence decreased from 19.7% in 2021 to 16.0% in 2023, and in the intervention arm, from 18.7% to 13.7%. No significant difference between arms in the change in parasite prevalence was estimated (adjusted relative risk=0.97, 95% CI=0.77 to 1.23). However, there was a small, ongoing decline in malaria incidence each month in proCCM clusters compared with control clusters (adjusted incidence rate ratio=0.98, 95% Bayesian credible interval=0.96 to 0.99). Our study suggests proCCM may modestly reduce malaria incidence over time in some settings with high baseline utilisation of routine facility and community case management. Trial registration number: NCT04839900.

Indexed as

Case ManagementCommunity Health ServicesMalariaAdultAntimalarialsChild, PreschoolCommunity Health WorkersFemaleHumansIncidenceInfantMalePrevalenceZambiaAntimalarialsMalaria

Identifiers

PMID40412814
PMCPMC12104936

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.