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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

BACKGROUND: The World Health Organization recommended (in 2010) universal testing for suspected malaria, due to some fundamental changes in malaria trends such as the declining incidence of malaria in high-burden countries, the emergence of parasite resistance to anti-malarial drugs especially artem...

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Autores principales: Omale, Ugwu I., Azuogu, Benedict N., Alo, Chihurumnanya, Madubueze, Ugochukwu C., Oka, Onyinyechukwu U., Okeke, Kingsley C., Okafor, Ifeyinwa M., Utulu, Rowland, Akpan, Uduak E., Iloke, Chijioke V., Nnubia, Anthonia O., Eze, Ifeyinwa I., Anene, Ogechukwu C., Nnabu, Chukwuka R., Ibemesi, Deborah C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785898/
https://www.ncbi.nlm.nih.gov/pubmed/31601250
http://dx.doi.org/10.1186/s13063-019-3620-0
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author Omale, Ugwu I.
Azuogu, Benedict N.
Alo, Chihurumnanya
Madubueze, Ugochukwu C.
Oka, Onyinyechukwu U.
Okeke, Kingsley C.
Okafor, Ifeyinwa M.
Utulu, Rowland
Akpan, Uduak E.
Iloke, Chijioke V.
Nnubia, Anthonia O.
Eze, Ifeyinwa I.
Anene, Ogechukwu C.
Nnabu, Chukwuka R.
Ibemesi, Deborah C.
author_facet Omale, Ugwu I.
Azuogu, Benedict N.
Alo, Chihurumnanya
Madubueze, Ugochukwu C.
Oka, Onyinyechukwu U.
Okeke, Kingsley C.
Okafor, Ifeyinwa M.
Utulu, Rowland
Akpan, Uduak E.
Iloke, Chijioke V.
Nnubia, Anthonia O.
Eze, Ifeyinwa I.
Anene, Ogechukwu C.
Nnabu, Chukwuka R.
Ibemesi, Deborah C.
author_sort Omale, Ugwu I.
collection PubMed
description BACKGROUND: The World Health Organization recommended (in 2010) universal testing for suspected malaria, due to some fundamental changes in malaria trends such as the declining incidence of malaria in high-burden countries, the emergence of parasite resistance to anti-malarial drugs especially artemisinin-based combination therapies (ACTs) and the increased availability of diagnostic testing such as the malaria rapid diagnostic test (MRDT). The Nigerian government has long adopted this recommendation and with the support of foreign partners has scaled up the availability of MRDT. However, the malaria/MRDT rate in the communities is still far short of the recommendation. This study aims to evaluate the effectiveness of social group and social group/provider interventions in increasing the demand (use and/or request) for MRDT among community members with fever or malaria-like illness in Ebonyi state, Nigeria. METHODS: A three-arm, parallel, stratified cluster randomized design will be used to evaluate the effect of two interventions compared to control: control involves the usual practice of provision of MRDT services by public primary healthcare providers and patent medicine vendors; social group intervention involves the sensitization/education of social groups about MRDT; social group/provider intervention involves social group treatment plus the training of healthcare providers in health communication about MRDT with clients. The primary outcome is the proportion of children under 5 years of age with fever/malaria-like illness, in the 2 weeks preceding a household survey, who received MRDT. The co-primary outcome is the proportion of children ages 5 years and above and adults (excluding pregnant women) with fever/malaria-like illness, in the 2 weeks preceding a household survey, who received MRDT. The primary outcome will be assessed through household surveys at baseline and at the end of the study. DISCUSSION: The pragmatic and behavioural nature of the interventions delivered to groups of individuals and the need to minimize contamination informed the use of a cluster-randomized design in this study in investigating whether the social group and social group/provider interventions will increase the demand for MRDT among community members. “Pragmatic” means the interventions would occur in natural settings or real- life situations. TRIAL REGISTRATION: ISRCTN, ISRCTN14046444. Registered on 14 August 2018. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13063-019-3620-0) contains supplementary material, which is available to authorized users.
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spelling pubmed-67858982019-10-17 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, Ugwu I. Azuogu, Benedict N. Alo, Chihurumnanya Madubueze, Ugochukwu C. Oka, Onyinyechukwu U. Okeke, Kingsley C. Okafor, Ifeyinwa M. Utulu, Rowland Akpan, Uduak E. Iloke, Chijioke V. Nnubia, Anthonia O. Eze, Ifeyinwa I. Anene, Ogechukwu C. Nnabu, Chukwuka R. Ibemesi, Deborah C. Trials Study Protocol BACKGROUND: The World Health Organization recommended (in 2010) universal testing for suspected malaria, due to some fundamental changes in malaria trends such as the declining incidence of malaria in high-burden countries, the emergence of parasite resistance to anti-malarial drugs especially artemisinin-based combination therapies (ACTs) and the increased availability of diagnostic testing such as the malaria rapid diagnostic test (MRDT). The Nigerian government has long adopted this recommendation and with the support of foreign partners has scaled up the availability of MRDT. However, the malaria/MRDT rate in the communities is still far short of the recommendation. This study aims to evaluate the effectiveness of social group and social group/provider interventions in increasing the demand (use and/or request) for MRDT among community members with fever or malaria-like illness in Ebonyi state, Nigeria. METHODS: A three-arm, parallel, stratified cluster randomized design will be used to evaluate the effect of two interventions compared to control: control involves the usual practice of provision of MRDT services by public primary healthcare providers and patent medicine vendors; social group intervention involves the sensitization/education of social groups about MRDT; social group/provider intervention involves social group treatment plus the training of healthcare providers in health communication about MRDT with clients. The primary outcome is the proportion of children under 5 years of age with fever/malaria-like illness, in the 2 weeks preceding a household survey, who received MRDT. The co-primary outcome is the proportion of children ages 5 years and above and adults (excluding pregnant women) with fever/malaria-like illness, in the 2 weeks preceding a household survey, who received MRDT. The primary outcome will be assessed through household surveys at baseline and at the end of the study. DISCUSSION: The pragmatic and behavioural nature of the interventions delivered to groups of individuals and the need to minimize contamination informed the use of a cluster-randomized design in this study in investigating whether the social group and social group/provider interventions will increase the demand for MRDT among community members. “Pragmatic” means the interventions would occur in natural settings or real- life situations. TRIAL REGISTRATION: ISRCTN, ISRCTN14046444. Registered on 14 August 2018. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13063-019-3620-0) contains supplementary material, which is available to authorized users. BioMed Central 2019-10-10 /pmc/articles/PMC6785898/ /pubmed/31601250 http://dx.doi.org/10.1186/s13063-019-3620-0 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Study Protocol
Omale, Ugwu I.
Azuogu, Benedict N.
Alo, Chihurumnanya
Madubueze, Ugochukwu C.
Oka, Onyinyechukwu U.
Okeke, Kingsley C.
Okafor, Ifeyinwa M.
Utulu, Rowland
Akpan, Uduak E.
Iloke, Chijioke V.
Nnubia, Anthonia O.
Eze, Ifeyinwa I.
Anene, Ogechukwu C.
Nnabu, Chukwuka R.
Ibemesi, Deborah C.
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785898/
https://www.ncbi.nlm.nih.gov/pubmed/31601250
http://dx.doi.org/10.1186/s13063-019-3620-0
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