Evidence map›Paper›PMID 42243746›Full record

Trial reportBMC pediatrics2026

Effectiveness of serial C-reactive protein point-of-care testing in optimizing antibiotic treatment in neonates and children in Zanzibar: an open-label, individual randomized controlled clinical trial protocol.

Daniel Joshua, Jeremiah Seni, Hanna Rahimi, Mayassa Salum Ally, Muhiddin Omar, Farid Said Ali, Jyoti Joshi, Said Mohammed Ali, Anja Poulsen, Stine Lund and 1 more

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Daniel JoshuaZanzibar Health Research Institute (ZAHRI), Zanzibar, Tanzania. danieljoshua36@yahoo.com.ORCID 0000-0002-1720-0506
Jeremiah SeniDepartment of Microbiology and Immunology, Weill-Bugando School of Medicine, Catholic University of Health and Allied Sciences (CUHAS), Mwanza, Tanzania.ORCID 0000-0003-2420-5329
Hanna RahimiDepartment of Paediatrics and Adolescent Medicine, Global Health Unit, Copenhagen University Hospital "Rigshospitalet", Copenhagen, Denmark.
Mayassa Salum AllyZanzibar Health Research Institute (ZAHRI), Zanzibar, Tanzania.
Muhiddin OmarDepartment of Preventive Services and Health Education, Ministry of Health, Zanzibar, Tanzania.
Farid Said AliPublic Health Laboratory Ivo de Carneri (PhL-IdC), Pemba Island, Tanzania.
Jyoti JoshiInternational Centre for Antimicrobial Resistance Solutions (ICARS), Copenhagen, Denmark.
Said Mohammed AliPublic Health Laboratory Ivo de Carneri (PhL-IdC), Pemba Island, Tanzania.
Anja Poulsen *Department of Paediatrics and Adolescent Medicine, Global Health Unit, Copenhagen University Hospital "Rigshospitalet", Copenhagen, Denmark.ORCID 0000-0002-9656-1552
Stine Lund *Department of Paediatrics and Adolescent Medicine, Global Health Unit, Copenhagen University Hospital "Rigshospitalet", Copenhagen, Denmark.
ZAN-TOTO Collaborators

Funding

International Centre for Antimicrobial Resistance Solutions (ICARS) 100021
6 · The paper itself

Abstract

introductionAntimicrobial resistance is increasing globally. Children are disproportionately affected due to the overuse and misuse of antibiotics which is linked to lack of prompt diagnostics for suspected bacterial infections, limited access to health care facilities and financial constraints. The C-reactive protein (CRP) point-of-care test (POCT) presents an opportunity for quick and cost-effective diagnosis to establish the likelihood of a bacterial infection. However, information on the effectiveness of point-of-care CRP testing in hospitalized children in Zanzibar, Tanzania is limited. METHODS AND ANALYSIS: This multicenter, open-label, individual randomized controlled trial with 28 days follow-up is conducted at four hospitals in Zanzibar. Well-appearing neonates at risk of early onset sepsis, neonates (0 - 28 days) with clinical signs of infection on admission and children (6 months - 12 years) with febrile illness and/or diarrhea on admission are eligible for participation if their caretakers provide informed consent. The hospitals are supplied with CRP POCT equipment as well as a training session on CRP interpretation to aid in the clinical evaluation and antibiotic management of neonates and children. The primary outcome is the duration of antibiotic treatment within 14 days of the admittance of included neonates and children in each study arm and days to relapse of infection (defined as reinstitution of antibiotics within 72 h after completion of treatment). ETHICS AND DISSEMINATION: The study is approved by the Zanzibar Health Research Ethics Committee Ref. No. ZAHREC/04/AMEND/DEC/2023/11. The findings from this study will be used to generate policy briefs and technical reports to inform rational antimicrobial prescriptions' clinical practices and guide future research. Findings will be presented at global conferences and published in peer-reviewed medical journals to foster access to wider communities within Tanzania and beyond.

trial registrationThis trial was registered with ISRCTN registry (ISRCTN25937092) on 22/01/2024.

Indexed as

Anti-Bacterial AgentsBacterial InfectionsC-Reactive ProteinPoint-of-Care TestingBiomarkersChildChild, PreschoolFemaleHumansInfantInfant, NewbornMaleRapid Diagnostic TestsTanzaniaAnti-Bacterial AgentsBiomarkersC-Reactive ProteinAntibiotics ZanzibarC-reactive proteinPoint-of-care testingTanzania

Identifiers

PMID42243746
PMCPMC13471330

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.