|
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
|
- 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.
- - 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.
