Using social groups and health care providers to increase the use of simple malaria tests in Ebonyi State, Nigeria

Conditions

Malaria Infections and Infestations Malaria

Omale UI, Azuogu BN, Alo C, Madubueze UC, Oka OU, Okeke KC, Okafor IM, Utulu R, Eze II, Akpan UE, Iloke CV, Nnubia AO, Anene OC, Nnabu CR, Ibemesi DO.

2021-03-017 citations

10.1016/s2214-109x(20)30508-8

Social group and health care provider interventions to increase the demand for malaria rapid diagnostic test among community members in Ebonyi state, Nigeria: study protocol for a cluster randomized controlled trial.

Omale UI, Azuogu BN, Alo C, Madubueze UC, Oka OU, Okeke KC, Okafor IM, Utulu R, Akpan UE, Iloke CV, Nnubia AO, Eze II, Anene OC, Nnabu CR, Ibemesi DC.

2019-10-102 citations

10.1186/s13063-019-3620-0

Interventions

Interventions as of 26/11/2018: Participants will be randomised into 3 groups in a 1:1:1 ratio through cluster randomisation by an independent statistician - the social group, social g

Eligibility

Inclusion criteria

Inclusion criteria: Current participant inclusion criteria as of 24/08/2018: Clusters: 1. Availability of eligible health care facilities: 1.1. At least one eligible public primary health care facility 1.2. At least one eligible patient medicine vendor (PMV) 2. Ease of access - closeness to a motorable road that is usable even in the rainy season Public primary health facilities: 1. Functionality 1.1. Provision of MRDT services 1.2. Provision of maternal and child health care services including immunisation 2. Attending to at least an average of four fever cases (or suspected cases of malaria) per day 3. Having at least 2 staff that are at least junior community health extension workers (JCHEWs) Patent medicine vendors (PMVs): 1. Have basic training in MRDT services 2. Either currently offering or previously offered MRDT services Individual public health care providers must have involvement in the diagnosis (and treatment) of malaria Social groups (women associations/meetings, village meetings, men associations, youth associations, elders’ fora, ward/community/village development committees etc) must be recognised by cluster heads/authorities. Households must have a report of any case of fever or suspected malaria among under-5 children, 5 years and above children, and adults (excluding pregnant women) in the household in the preceding two weeks to a population-based household survey. Previous participant inclusion criteria: Clusters: 1. Availability of eligible health care facilities: 1.1. At least one eligible public primary health care facility 1.2. At least one eligible private health facility or PMV (patient medicine vendor) 2. Ease of access - closeness to a motorable road that is usable even in the rainy season Public primary health facilities: 1. Functionality 1.1. Provision of MRDT services 1.2. Provision of maternal and child health care services including immunisation 2. Attending to at least an average of four fever cases (or suspected cases of malaria) per day 3. Having at least 3 staff that are at least junior community health extension workers (JCHEWs) Individual private health care providers and patent medicine vendors (PMVs): 1. Have basic training in MRDT services 2. Either currently offering or previously offered MRDT services Individual public health care providers must have involvement in the diagnosis (and treatment) of malaria Social groups (women associations/meetings, village meetings, men associations, youth associations, elders’ fora, ward/community/village development committees etc) must be recognised by cluster heads/authorities. Households must have a report of any case of fever or suspected malaria among under-5 children, 5 years and above children, and adults (excluding pregnant women) in the household in the preceding two weeks to a population-based household survey.

Exclusion criteria

Exclusion criteria: For clusters: 1. Participation in similar interventions within the preceding year 2. Clusters that are too close (less than 15 km apart) and not separated by a buffer area or natural barrier 3. Urban clusters (in cities/towns) 4. No consent provided For all other participant groups, non-consenting participants will be excluded from the study.

Design outcomes

Primary

Measure	Time frame
Current primary outcome measures as of 29/09/2020: The following will be assessed through a population-based household questionnaire at the baseline and 3 months after the end of the intervention: 1.1. The proportion of children under 5 years of age with fever or malaria-like illness, in the 2 weeks preceding a population-based household survey, who received MRDT 1.2. The proportion of children ages 5 years and above and adults (excluding pregnant women) with fever or malaria-like illness, in the 2 weeks preceding a population-based household survey, who received MRDT Previous primary outcome measures: The following will be assessed through a population-based household questionnaire at the baseline and 3 months after the end of the intervention: 1. The proportion of children under 5 years old with a fever or malaria-like illness in the preceding 2 weeks that received MRDT 1.1. The proportion of these children for whom their caregivers requested MRDT 2. The proportion of children aged 5 years and above and adults (excluding pregnant women) with a fever or malaria-like illness in the preceding 2 weeks that received MRDT 2.1. The proportion of these subjects that requested or whose caregivers requested MRDT	—

Measure

Time frame

Current primary outcome measures as of 29/09/2020: The following will be assessed through a population-based household questionnaire at the baseline and 3 months after the end of the intervention: 1.1. The proportion of children under 5 years of age with fever or malaria-like illness, in the 2 weeks preceding a population-based household survey, who received MRDT 1.2. The proportion of children ages 5 years and above and adults (excluding pregnant women) with fever or malaria-like illness, in the 2 weeks preceding a population-based household survey, who received MRDT Previous primary outcome measures: The following will be assessed through a population-based household questionnaire at the baseline and 3 months after the end of the intervention: 1. The proportion of children under 5 years old with a fever or malaria-like illness in the preceding 2 weeks that received MRDT 1.1. The proportion of these children for whom their caregivers requested MRDT 2. The proportion of children aged 5 years and above and adults (excluding pregnant women) with a fever or malaria-like illness in the preceding 2 weeks that received MRDT 2.1. The proportion of these subjects that requested or whose caregivers requested MRDT

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Secondary

Measure	Time frame
Current secondary outcome measures as of 29/09/2020: The following will be assessed through a population-based Household Member's Questionnaire at the baseline and 3 months after the end of the intervention: 1. The proportion of these children under 5 years of age, who received MRDT, whose caregivers requested the MRDT 2. The proportion of these children ages 5 years and above and adults, who received MRDT, who requested or whose caregivers requested the MRDT 3. The proportion of children under 5 years old with a fever or malaria-like illness in the preceding 2 weeks: 3.1. Whose caregivers sought care with a provider 3.2. Those that sought care the same or next day 3.3. For those for whom care was sought, the type of provider with whom care was sought 3.4. The proportion of these children that took any anti-malarial drug 3.5. The proportion of these children that took ACTs 4. The proportion of children aged 5 years and above and adults (excluding pregnant women) with a fever or malaria-like illness in the preceding 2 weeks: 4.1. That sought care with a provider 4.2. That sought care the same or next day 4.3. Amongst those that sought care, the type of provider with whom care was sought 4.4. The proportion of these children and adults that took any anti-malarial drug 4.5. The proportion of these children and adults that took ACTs 5. The proportion of respondent female heads of households (female primary caregivers) that have good knowledge and opinion about malaria and malaria diagnosis 6. The number of suspected malaria cases visiting the public primary health centres measured using patients’ register 7. The proportion of providers that have good knowledge and opinion and practice of	—

Measure

Time frame

Current secondary outcome measures as of 29/09/2020: The following will be assessed through a population-based Household Member's Questionnaire at the baseline and 3 months after the end of the intervention: 1. The proportion of these children under 5 years of age, who received MRDT, whose caregivers requested the MRDT 2. The proportion of these children ages 5 years and above and adults, who received MRDT, who requested or whose caregivers requested the MRDT 3. The proportion of children under 5 years old with a fever or malaria-like illness in the preceding 2 weeks: 3.1. Whose caregivers sought care with a provider 3.2. Those that sought care the same or next day 3.3. For those for whom care was sought, the type of provider with whom care was sought 3.4. The proportion of these children that took any anti-malarial drug 3.5. The proportion of these children that took ACTs 4. The proportion of children aged 5 years and above and adults (excluding pregnant women) with a fever or malaria-like illness in the preceding 2 weeks: 4.1. That sought care with a provider 4.2. That sought care the same or next day 4.3. Amongst those that sought care, the type of provider with whom care was sought 4.4. The proportion of these children and adults that took any anti-malarial drug 4.5. The proportion of these children and adults that took ACTs 5. The proportion of respondent female heads of households (female primary caregivers) that have good knowledge and opinion about malaria and malaria diagnosis 6. The number of suspected malaria cases visiting the public primary health centres measured using patients’ register 7. The proportion of providers that have good knowledge and opinion and practice of

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Countries

Nigeria

Outcome results

None listed