Correction to: Incentivizing appropriate malaria case management in the private sector: a study protocol for two linked cluster randomized controlled trials to evaluate provider- and client-focused interventions in western Kenya and Lagos, Nigeria

Woolsey, Aaron M.; Simmons, Ryan; Woldeghebriel, Meley; Zhou, Yunji; Ogunsola, Oluwatosin; Laing, Sarah; Olaleye, Tayo; Kipkoech, Joseph; Rojas, Bomar Mendez; Saran, Indrani; Odhiambo, Mercy; Malinga, Josephine; Ambani, George; Kimachas, Emmah; Fashanu, Chizoba; Wiwa, Owens; Menya, Diana; Laktabai, Jeremiah; Visser, Theodoor; Turner, Elizabeth L.; O’Meara, Wendy Prudhomme

doi:10.1186/s13012-021-01093-4

Cited by 4 publications

(3 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The study was reviewed and approved by CHAI's Scientific and Ethical Review Committee (SERC) on October 22 nd 2019; Duke University Institutional Review Board (Pro00104256) and the Health Research and Ethics Committee Secretariat (HREC) at the Lagos State University Teaching Hospital (LASUTH) (LREC/06/10/1304) in Lagos, Nigeria. The study is registered in ClinicalTrials.gov (NCT04428307) and the protocol and revisions to the original design were published in advance [9,10].…”

Section: Ethical Considerations and Trial Registrationmentioning

confidence: 99%

“…These results are pending publication elsewhere [8] . Full details of the study design were previously reported in Woolsey et al [9,10].…”

Section: Overall Study Designmentioning

confidence: 99%

“…The recruitment period for the 2-arm design started March 1 st , 2022, and ran until February 28 th , 2023. For a detailed explanation of the change from the originally planned 4-arm design to a 2-arm design please refer to Woolsey et al [10].…”

mentioning

confidence: 99%

See 2 more Smart Citations

A cluster-randomized trial of client and provider directed financial interventions to align incentives with appropriate case management in private medicine retailers: results of the TESTsmART Trial in Lagos, Nigeria

Visser,

Laktabai,

Kimachas

et al. 2024

Preprint

View full text Add to dashboard Cite

Malaria remains a major health priority in Nigeria. Among children with fever who seek care, less than a quarter gets tested for malaria, leading to inappropriate use of the recommended treatment for malaria; Artemether Combination Therapies (ACT). Here we test an innovative strategy to target ACT subsidies to clients seeking care in Nigeria’s private retail health sector who have a confirmed malaria diagnosis. We supported point-of-care malaria testing (mRDTs) in 48 Private Medicine Retailers (PMRs) in the city of Lagos, Nigeria and randomized them to two study arms; a control arm offering subsidized mRDT testing for USD $0.66, and an intervention arm where, in addition to access to subsidized testing as in the control arm, clients who received a positive mRDT at the outlet were eligible for a free (fully subsidized) first-line ACT and outlets received USD $0.2 for every mRDT performed. Our primary outcome was the proportion of ACTs dispensed to individuals with a positive diagnostic test. Secondary outcomes included proportion of clients who were tested at the outlet and adherence to diagnostic test results. Overall, 23% of clients chose to test at the outlet. Test results seemed to inform treatment decisions and resulted in enhanced targeting of ACTs to confirmed malaria cases with only 26% of test-negative clients purchasing an ACT compared to 58% of untested clients. However, the intervention did not offer further improvements, compared to the control arm, in testing rates or dispensing of ACTs to test-positive clients. We found that ACT subsidies were not passed on to clients testing positive in the intervention arm. We conclude that RDTs could reduce ACT overconsumption in Nigeria’s private retail health sector, but outlet-oriented incentive structures are difficult to implement and may need to be complemented with interventions targeting clients of PMRs to increase test uptake and adherence.

show abstract

Section: Ethical Considerations and Trial Registrationmentioning

confidence: 99%

“…These results are pending publication elsewhere [8] . Full details of the study design were previously reported in Woolsey et al [9,10].…”

Section: Overall Study Designmentioning

confidence: 99%

See 1 more Smart Citation

A cluster-randomized trial of client and provider directed financial interventions to align incentives with appropriate case management in private medicine retailers: results of the TESTsmART Trial in Lagos, Nigeria

Visser,

Laktabai,

Kimachas

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Constrained randomization and statistical inference for multi‐arm parallel cluster randomized controlled trials

Zhou

Turner

Simmons

et al. 2022

Statistics in Medicine

Self Cite

View full text Add to dashboard Cite

A practical limitation of cluster randomized controlled trials (cRCTs) is that the number of available clusters may be small, resulting in an increased risk of baseline imbalance under simple randomization. Constrained randomization overcomes this issue by restricting the allocation to a subset of randomization schemes where sufficient overall covariate balance across comparison arms is achieved. However, for multi-arm cRCTs, several design and analysis issues pertaining to constrained randomization have not been fully investigated. Motivated by an ongoing multi-arm cRCT, we elaborate the method of constrained randomization and provide a comprehensive evaluation of the statistical properties of model-based and randomization-based tests under both simple and constrained randomization designs in multi-arm cRCTs, with varying combinations of design and analysis-based covariate adjustment strategies. In particular, as randomization-based tests have not been extensively studied in multi-arm cRCTs, we additionally develop most-powerful randomization tests under the linear mixed model framework for our comparisons. Our results indicate that under constrained randomization, both model-based and randomization-based analyses could gain power while preserving nominal type I error rate, given proper analysis-based adjustment for the baseline covariates. Randomization-based analyses, however, are more robust against violations of distributional assumptions. The choice of balance metrics and candidate set sizes and their implications on the testing of the pairwise and global hypotheses are also discussed. Finally, we caution against the design and analysis of multi-arm cRCTs with an extremely small number of clusters, due to insufficient degrees of freedom and the tendency to obtain an overly restricted randomization space.

show abstract

Impact of Malaria Diagnostic Technologies on the Disease Burden in the Sub-Saharan Africa

Wambani

Okoth

2022

Journal of Tropical Medicine

View full text Add to dashboard Cite

Worldwide, transmission of emerging and reemerging malaria infections poses a significant threat to human health in the Sub-Saharan Africa, one that can quickly overwhelm public health resources. While the disease burden of malaria in the Sub-Saharan Africa appears to be on a gradual decline, it is characterized by spatial and temporal variability occasioning a sorry state for the Global South Countries. New evidence on long-term complications of malaria heightens our awareness of its public health impact. Given the likelihood of misdiagnosis, and the unknown levels of malaria transmission across different landscapes, many missed opportunities for prevention occur. Africa’s population growth, unplanned urbanization, habitat destruction, and trans-border travel are contributing to a rise in the calamitous epidemiology of malaria. Despite empirical statistics demonstrating a downward trend in the malaria disease burden attributable to the scale-up of multiple control strategies, including new diagnostic technologies, malaria remains a global threat to human health in Sub-Sahara Africa. Malaria is a severe public health threat globally, despite several advancements and innovations in its control. Six species of the genus Plasmodium including Plasmodium malariae, Plasmodium falciparum, Plasmodium cynomolgi, Plasmodium knowlesi, Plasmodium ovale, and Plasmodium vivax are known to infect humans. However, greatest disease burden and fatalities are caused by Plasmodium falciparum. Globally, about 3 billion individuals are at risk of contracting malaria disease every year, with over 400,000 fatalities reported in the Sub-Saharan Africa. World Health Organization (WHO) 2018 malaria report indicated that approximately 405,000 mortalities and 228 million cases were reported worldwide, with Africa carrying the highest disease burden. Over the last decade, there has been a significant decline in malaria deaths and infections, which may be related to the availability of effective diagnostic techniques. However, in certain areas, the rate of decline has slowed or even reversed the gains made so far. Accurate diagnosis, adequate treatment, and management of the disease are critical WHO-set goals of eliminating malaria by 2030. Microscopy, rapid diagnostic tests (RDTs), nucleic acid amplification tests (NAATs), and biosensors are all currently accessible diagnostic methods. These technologies have substantial flaws and triumphs that could stymie or accelerate malaria eradication efforts. The cost, ease, accessibility, and availability of skilled persons all influence the use of these technologies. These variables have a direct and indirect ramification on the entire management portfolio of patients. Despite the overall decline in the malaria disease burden driven partly by new diagnostic technologies, a sobering pattern marked by limited number of studies and spatial as well as temporal heterogeneity remains a concern. This review summarizes the principle, performance, gaps, accomplishments, and applicability of numerous malaria diagnostic techniques and their potential role in reducing the malaria disease burden in Sub-Saharan Africa.

show abstract

Correction to: Incentivizing appropriate malaria case management in the private sector: a study protocol for two linked cluster randomized controlled trials to evaluate provider- and client-focused interventions in western Kenya and Lagos, Nigeria

Abstract: An amendment to this paper has been published and can be accessed via the original article.

Cited by 4 publications

References 1 publication

A cluster-randomized trial of client and provider directed financial interventions to align incentives with appropriate case management in private medicine retailers: results of the TESTsmART Trial in Lagos, Nigeria

A cluster-randomized trial of client and provider directed financial interventions to align incentives with appropriate case management in private medicine retailers: results of the TESTsmART Trial in Lagos, Nigeria

Constrained randomization and statistical inference for multi‐arm parallel cluster randomized controlled trials

Impact of Malaria Diagnostic Technologies on the Disease Burden in the Sub-Saharan Africa

Contact Info

Product

Resources

About