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Table 4 Effect of interventions on recommended antimalarial prescribing among patients with a non-severe, non-malarial illness

From: Prescriber and patient-oriented behavioural interventions to improve use of malaria rapid diagnostic tests in Tanzania: facility-based cluster randomised trial

Evaluation category Arm Number of clusters Number of patients Prevalence number (%) Crude RD a (95% CI) Adjusted RD b (95% CI) P -value
Overallc(all ages) Control 12 8942 749 (8%) 0 0  
HW 12 10118 250 (2%) 0.06 (0.04, 0.09) 0.04 (0.01, 0.06) 0.008
HWP 12 10163 184 (2%) 0.07 (0.04, 0.09) 0.04 (0.01, 0.06) 0.005
<5 years Control 12 3139 392 (12%) 0 0  
HW 12 3682 153 (4%) 0.09 (0.04, 0.14) 0.06 (0.006, 0.12) 0.03
HWP 12 3406 95 (3%) 0.09 (0.03, 0.14) 0.05 (0.005, 0.09) 0.03
≥5 years Control 12 5803 357 (6%) 0 0  
HW 12 6436 97 (2%) 0.05 (0.03, 0.07) 0.02 (0.006, 0.04) 0.008
HWP 12 6757 89 (1%) 0.05 (0.03, 0.07) 0.03 (0.01, 0.05) 0.002
By Evaluation period
Standard training - period 1 (all arms) Control 12 656 48 (7%) 0 0  
HW 9 449 3 (1%) - - -
HWP 11 494 38 (8%) 0.001 (−0.09, 0.09) −0.01 (−0.06, 0.03) 0.54
Interactive training - period 2 (HW and HWP arms) Control 12 3320 236 (7%) 0 0  
HW 12 3791 135 (4%) 0.05 (0.02, 0.08) 0.02 (−0.001, 0.05) 0.06
HWP 12 3802 81 (2%) 0.05 (0.02, 0.09) 0.03 (0.003, 0.05) 0.03
Feedback SMS – period 3 (HW and HWP arms) Control 12 2392 215 (9%) 0 0  
HW 12 2829 58 (2%) 0.06 (0.04, 0.09) 0.02 (−0.001, 0.05) 0.06
HWP 12 2891 24 (1%) 0.07 (0.04, 0.10) 0.02 (−0.004, 0.04) 0.09
Feedback + proverb SMS - period 4 (HW and HWP arms) Control 12 1297 106 (8%) 0 0  
HW 12 1540 18 (1%) 0.07 (0.05, 0.09) 0.03 (0.007, 0.06) 0.01
HWP 12 1607 7 (0.4%) 0.07 (0.05, 0.09) 0.03 (0.01, 0.06) 0.009
  1. aAdjusted for stratification, effect estimate is risk difference = control– intervention; control is standard RDT training. bAdjusted for facility (stratum, stock-out of ACT, provision of materials, % fever consultations treated with antimalarial prior to the study, % non-febrile consultations treated with antimalarial prior to the study), prescriber (age, education, time at facility) and patient (age) characteristics.
  2. - Insufficient number of clusters or sample size per cluster to conduct a robust analysis. cDefined as the period of evaluation from the end of the standard RDT training until the end of the trial. The between-cluster coefficient of variation was estimated as k = 0.02 for comparison of both intervention arms with the control. ACT, artemisinin-based combination therapies; CI, confidence interval; HW, health worker; HWP, health worker plus patient-oriented; RD, risk difference; RDT, rapid diagnostic test; SMS, mobile-phone text message.