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Trials
Published in: Trials 1/2012

Open Access 01-12-2012 | Study protocol

A cost-effectiveness analysis of provider and community interventions to improve the treatment of uncomplicated malaria in Nigeria: study protocol for a randomized controlled trial

Authors: Virginia Wiseman, Ezeoke Ogochukwu, Nwala Emmanuel, Mangham Lindsay J, Cundill Bonnie, Enemuo Jane, Uchegbu Eloka, Uzochukwu Benjamin, Onwujekwe Obinna

Published in: Trials | Issue 1/2012

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Abstract

Background

There is mounting evidence of poor adherence by health service personnel to clinical guidelines for malaria following a symptomatic diagnosis. In response to this, the World Health Organization (WHO) recommends that in all settings clinical suspicion of malaria should be confirmed by parasitological diagnosis using microscopy or Rapid Diagnostic Test (RDT). The Government of Nigeria plans to introduce RDTs in public health facilities over the coming year. In this context, we will evaluate the effectiveness and cost-effectiveness of two interventions designed to support the roll-out of RDTs and improve the rational use of ACTs. It is feared that without supporting interventions, non-adherence will remain a serious impediment to implementing malaria treatment guidelines.

Methods/design

A three-arm stratified cluster randomized trial is used to compare the effectiveness and cost-effectiveness of: (1) provider malaria training intervention versus expected standard practice in malaria diagnosis and treatment; (2) provider malaria training intervention plus school-based intervention versus expected standard practice; and (3) the combined provider plus school-based intervention versus provider intervention alone. RDTs will be introduced in all arms of the trial. The primary outcome is the proportion of patients attending facilities that report a fever or suspected malaria and receive treatment according to malaria guidelines. This will be measured by surveying patients (or caregivers) as they exit primary health centers, pharmacies, and patent medicine dealers. Cost-effectiveness will be presented in terms of the primary outcome and a range of secondary outcomes, including changes in provider and community knowledge. Costs will be estimated from both a societal and provider perspective using standard economic evaluation methodologies.

Trial registration

Clinicaltrials.gov NCT01350752
Appendix
Available only for authorised users
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Metadata
Title
A cost-effectiveness analysis of provider and community interventions to improve the treatment of uncomplicated malaria in Nigeria: study protocol for a randomized controlled trial
Authors
Virginia Wiseman
Ezeoke Ogochukwu
Nwala Emmanuel
Mangham Lindsay J
Cundill Bonnie
Enemuo Jane
Uchegbu Eloka
Uzochukwu Benjamin
Onwujekwe Obinna
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Trials / Issue 1/2012
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-13-81

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