Evidence on the impact of using diagnostic tests in community case management of febrile children is limited. This effectiveness trial conducted in Burkina Faso, Ghana, and Uganda, compared a diagnostic and treatment package for malaria and pneumonia with presumptive treatment with anti-malarial drugs; artemisinin combination therapy (ACT). We enrolled 4, 216 febrile children between 4 and 59 months of age in 2009-2010. Compliance with the malaria rapid diagnostic test (RDT) results was high in the intervention arm across the three countries, with only 4.9% (17 of 344) of RDT-negative children prescribed an ACT. Antibiotic overuse was more common: 0.9% (4 of 446) in Uganda, 38.5% (114 of 296) in Burkina Faso, and 44.6% (197 of 442) in Ghana. Fever clearance was high in both intervention and control arms at both Day 3 (97.8% versus 96.9%, P = 0.17) and Day 7 (99.2% versus 98.8%, P = 0.17). The use of diagnostic tests limits overuse of ACTs. Its impact on antibiotic overuse and on fever clearance is uncertain. Copyright © 2012 by The American Society of Tropical Medicine and Hygiene.
CITATION STYLE
Mukanga, D., Tiono, A. B., Anyorigiya, T., Källander, K., Konaté, A. T., Oduro, A. R., … Pagnoni, F. (2012). Integrated community case management of fever in children under five using rapid diagnostic tests and respiratory rate counting: A multi-country cluster randomized trial. American Journal of Tropical Medicine and Hygiene, 87(SUPPL.5), 21–29. https://doi.org/10.4269/ajtmh.2012.11-0816
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