Introducing rapid diagnostic tests for malaria into drug shops in Uganda: design and implementation of a cluster randomized trial

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Introducing rapid diagnostic tests for malaria into drug shops in Uganda : design and implementation of a cluster randomized trial. / Mbonye, Anthony K; Magnussen, Pascal; Chandler, Clare Ir; Hansen, Kristian Schultz; Lal, Sham; Cundill, Bonnie; Lynch, Caroline A; Clarke, Siân E.

I: Trials, Bind 15, 303, 2014.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Mbonye, AK, Magnussen, P, Chandler, CI, Hansen, KS, Lal, S, Cundill, B, Lynch, CA & Clarke, SE 2014, 'Introducing rapid diagnostic tests for malaria into drug shops in Uganda: design and implementation of a cluster randomized trial', Trials, bind 15, 303. https://doi.org/10.1186/1745-6215-15-303

APA

Mbonye, A. K., Magnussen, P., Chandler, C. I., Hansen, K. S., Lal, S., Cundill, B., ... Clarke, S. E. (2014). Introducing rapid diagnostic tests for malaria into drug shops in Uganda: design and implementation of a cluster randomized trial. Trials, 15, [303]. https://doi.org/10.1186/1745-6215-15-303

Vancouver

Mbonye AK, Magnussen P, Chandler CI, Hansen KS, Lal S, Cundill B o.a. Introducing rapid diagnostic tests for malaria into drug shops in Uganda: design and implementation of a cluster randomized trial. Trials. 2014;15. 303. https://doi.org/10.1186/1745-6215-15-303

Author

Mbonye, Anthony K ; Magnussen, Pascal ; Chandler, Clare Ir ; Hansen, Kristian Schultz ; Lal, Sham ; Cundill, Bonnie ; Lynch, Caroline A ; Clarke, Siân E. / Introducing rapid diagnostic tests for malaria into drug shops in Uganda : design and implementation of a cluster randomized trial. I: Trials. 2014 ; Bind 15.

Bibtex

@article{bcfcb58e4b37465aa9b2578821080c60,
title = "Introducing rapid diagnostic tests for malaria into drug shops in Uganda: design and implementation of a cluster randomized trial",
abstract = "BACKGROUND: An intervention was designed to introduce rapid diagnostics tests for malaria (mRDTs) into registered drug shops in Uganda to encourage rational and appropriate treatment of malaria with artemisinin-based combination therapy (ACT). We conducted participatory training of drug shop vendors and implemented supporting interventions to orientate local communities (patients) and the public sector (health facility staff and district officials) to the behavioral changes in diagnosis, treatment and referral being introduced in drug shops. The intervention was designed to be evaluated through a cluster randomized trial. In this paper, we present detailed design, implementation and evaluation experiences in order to help inform future studies of a complex nature.METHODS: Three preparatory studies (formative, baseline and willingness-to-pay) were conducted to explore perceptions on diagnosis and treatment of malaria at drug shops, and affordable prices for mRDTs and ACTs in order to inform the design of the intervention and implementation modalities. The intervention required careful design with the intention to be acceptable, sustainable and effective. Critical components of intervention were: community sensitization and creating awareness, training of drug shop vendors to diagnose malaria with mRDTs, treat and refer customers to formal health facilities, giving pre-referral rectal artesunate and improved record-keeping. The primary outcome was the proportion of patients receiving appropriately-targeted treatment with ACT, evaluated against microscopy on a research blood slide.RESULTS: Introducing mRDTs in drug shops may seem simple, but our experience of intervention design, conduct and evaluation showed this to be a complex process requiring multiple interventions and evaluation components drawing from a combination of epidemiological, social science and health economics methodologies. The trial was conducted in phases sequenced such that each benefited from the other.CONCLUSIONS: The main challenges in designing this trial were maintaining a balance between a robust intervention to support effective behaviour change and introducing practices that would be sustainable in a real-life situation in tropical Africa; as well as achieving a detailed evaluation without inadvertently influencing prescribing behaviour.Trial registration: Trial registration: NCT01194557 registered with ClinicalTrials.gov 2 September 2010.",
author = "Mbonye, {Anthony K} and Pascal Magnussen and Chandler, {Clare Ir} and Hansen, {Kristian Schultz} and Sham Lal and Bonnie Cundill and Lynch, {Caroline A} and Clarke, {Si{\^a}n E}",
year = "2014",
doi = "10.1186/1745-6215-15-303",
language = "English",
volume = "15",
journal = "Trials",
issn = "1745-6215",
publisher = "BioMed Central Ltd.",

}

RIS

TY - JOUR

T1 - Introducing rapid diagnostic tests for malaria into drug shops in Uganda

T2 - design and implementation of a cluster randomized trial

AU - Mbonye, Anthony K

AU - Magnussen, Pascal

AU - Chandler, Clare Ir

AU - Hansen, Kristian Schultz

AU - Lal, Sham

AU - Cundill, Bonnie

AU - Lynch, Caroline A

AU - Clarke, Siân E

PY - 2014

Y1 - 2014

N2 - BACKGROUND: An intervention was designed to introduce rapid diagnostics tests for malaria (mRDTs) into registered drug shops in Uganda to encourage rational and appropriate treatment of malaria with artemisinin-based combination therapy (ACT). We conducted participatory training of drug shop vendors and implemented supporting interventions to orientate local communities (patients) and the public sector (health facility staff and district officials) to the behavioral changes in diagnosis, treatment and referral being introduced in drug shops. The intervention was designed to be evaluated through a cluster randomized trial. In this paper, we present detailed design, implementation and evaluation experiences in order to help inform future studies of a complex nature.METHODS: Three preparatory studies (formative, baseline and willingness-to-pay) were conducted to explore perceptions on diagnosis and treatment of malaria at drug shops, and affordable prices for mRDTs and ACTs in order to inform the design of the intervention and implementation modalities. The intervention required careful design with the intention to be acceptable, sustainable and effective. Critical components of intervention were: community sensitization and creating awareness, training of drug shop vendors to diagnose malaria with mRDTs, treat and refer customers to formal health facilities, giving pre-referral rectal artesunate and improved record-keeping. The primary outcome was the proportion of patients receiving appropriately-targeted treatment with ACT, evaluated against microscopy on a research blood slide.RESULTS: Introducing mRDTs in drug shops may seem simple, but our experience of intervention design, conduct and evaluation showed this to be a complex process requiring multiple interventions and evaluation components drawing from a combination of epidemiological, social science and health economics methodologies. The trial was conducted in phases sequenced such that each benefited from the other.CONCLUSIONS: The main challenges in designing this trial were maintaining a balance between a robust intervention to support effective behaviour change and introducing practices that would be sustainable in a real-life situation in tropical Africa; as well as achieving a detailed evaluation without inadvertently influencing prescribing behaviour.Trial registration: Trial registration: NCT01194557 registered with ClinicalTrials.gov 2 September 2010.

AB - BACKGROUND: An intervention was designed to introduce rapid diagnostics tests for malaria (mRDTs) into registered drug shops in Uganda to encourage rational and appropriate treatment of malaria with artemisinin-based combination therapy (ACT). We conducted participatory training of drug shop vendors and implemented supporting interventions to orientate local communities (patients) and the public sector (health facility staff and district officials) to the behavioral changes in diagnosis, treatment and referral being introduced in drug shops. The intervention was designed to be evaluated through a cluster randomized trial. In this paper, we present detailed design, implementation and evaluation experiences in order to help inform future studies of a complex nature.METHODS: Three preparatory studies (formative, baseline and willingness-to-pay) were conducted to explore perceptions on diagnosis and treatment of malaria at drug shops, and affordable prices for mRDTs and ACTs in order to inform the design of the intervention and implementation modalities. The intervention required careful design with the intention to be acceptable, sustainable and effective. Critical components of intervention were: community sensitization and creating awareness, training of drug shop vendors to diagnose malaria with mRDTs, treat and refer customers to formal health facilities, giving pre-referral rectal artesunate and improved record-keeping. The primary outcome was the proportion of patients receiving appropriately-targeted treatment with ACT, evaluated against microscopy on a research blood slide.RESULTS: Introducing mRDTs in drug shops may seem simple, but our experience of intervention design, conduct and evaluation showed this to be a complex process requiring multiple interventions and evaluation components drawing from a combination of epidemiological, social science and health economics methodologies. The trial was conducted in phases sequenced such that each benefited from the other.CONCLUSIONS: The main challenges in designing this trial were maintaining a balance between a robust intervention to support effective behaviour change and introducing practices that would be sustainable in a real-life situation in tropical Africa; as well as achieving a detailed evaluation without inadvertently influencing prescribing behaviour.Trial registration: Trial registration: NCT01194557 registered with ClinicalTrials.gov 2 September 2010.

U2 - 10.1186/1745-6215-15-303

DO - 10.1186/1745-6215-15-303

M3 - Journal article

C2 - 25069975

VL - 15

JO - Trials

JF - Trials

SN - 1745-6215

M1 - 303

ER -

ID: 119725137