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Table 2 Description of study design and interventions

From: Patients with positive malaria tests not given artemisinin-based combination therapies: a research synthesis describing under-prescription of antimalarial medicines in Africa

Project site

Study design

Primary study intervention arms

Categorisation of intervention arms used in this study

Cam1

Cluster randomised trial

Basic intervention: 1-day training on malaria diagnosis, mRDTs, and prescribing antimalarials. Enhanced intervention: additional 2-day training on adapting to guideline changes, identifying alternative causes of febrile illnesses, and communication skills. (Primary study included control group with no training or receipt of mRDTs)

No/basic training: includes those from the basic intervention arm

BC arm: includes those from the enhanced training arm

Ghan1

Individually randomised trial

Intervention: 2-day training in sensitivity and specificity of mRDTs, performing mRDTs, prescribing antimalarials, identifying alternative causes of febrile illnesses, and refresher on national guidelines. (Primary study included control group practising current standard of care: presumptive diagnosis (clinical setting) or microscopy (microscopy setting))

No/basic training: includes those from the intervention arm (NB comparison group did not use mRDTs, and was therefore excluded from this analysis)

Nige1

Cluster randomised trial

Control: half-day demonstration on use of mRDTs, plus receipt of pictorial aid. Basic intervention: 2-day training on performing mRDTs, prescribing antimalarials, and communication skills. Enhanced intervention: additional community sensitisation element including teacher/student education for malaria awareness. (Primary study also included a formative study)

No/basic training: includes those from the control arm

BC arm: includes those from the basic intervention arm

BC + CS arm: includes those from the enhanced intervention arm

Tanz1

Observational study (during national rollout of mRDTs)

Intervention: 2-day government training on performing mRDTs, prescribing antimalarials, rationale for guideline change, and identifying alternative causes of febrile illnesses. (Primary study included baseline and endline surveys for evaluation)

No/basic training: includes those that undertook government training (NB comparison group did not use mRDTs, and was therefore excluded from this analysis)

Tanz2

Baseline survey followed by cluster randomised trial

Control: 2-day government training on performing mRDTs, prescribing antimalarials, rationale for guideline change, and identifying alternative causes of febrile illnesses. Intervention: three half-day workshops on adapting to and sustaining guideline changes, and communication skills. Enhanced intervention: as above (intervention) plus receipt of additional visual communication resources for patients and facilities. (Primary study included a pilot study with 1-day basic training on mRDT use)

No/basic training: includes those from control arm

BC arm: includes those from the intervention arm

BC + CS arm: includes those from the enhanced intervention arm

Uga1

Cluster randomised trial

Intervention: 2-day training on performing mRDTs, prescribing antimalarials, identifying alternative causes of febrile illnesses, and communication skills. (Primary study included patients in the control group tested by mRDT if already available in health care facility, but training on use and interpretation of mRDTs not supplied by study)

No/basic training: includes those from the control arm that were tested by mRDTs not supplied by the study

BC arm: includes those from the intervention arm

Uga2

Cluster randomised trial

Intervention: 4-day training on performing and reading mRDTs, prescribing antimalarials, dealing with negative cases, communication skills, community sensitisation for diagnostic testing, plus visual communication resources for health care workers. (Primary study included control group receiving 3-day training in malaria diagnosis and referral (but not in use of mRDTs), and community sensitisation for diagnostic testing)

BC + CS arm: includes those from the intervention arm (NB comparison group did not use mRDTs, and was therefore excluded from this analysis)

Uga3

Cluster randomised trial

Intervention: 4-day training for drug shop vendors in performing and reading mRDTs, prescribing antimalarials, dealing with negative cases, communication skills, and community sensitisation for diagnostic testing. (Primary study included formative study, and control group receiving 3-day training in malaria diagnosis and referral (but not in use of mRDTs), and community sensitisation for diagnostic testing)

BC + CS arm: includes those from the intervention arm (NB comparison group did not use mRDTs, and was therefore excluded from this analysis)

  1. BC enhanced training arm with behaviour change component, BC + CS enhanced training arm with behaviour change and community sensitisation components