Development of a simple protocol to enhance compliance in home management of malaria

ISRCTN	ISRCTN05620936
DOI	https://doi.org/10.1186/ISRCTN05620936
Protocol serial number	N/A
Sponsor	University of Ibadan (Nigeria)
Funder	Investigator funded (Nigeria)

Submission date: 22/10/2007
Registration date: 30/10/2007
Last edited: 30/10/2007

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Infections and Infestations

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Record updated in last year

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Ikeoluwapo Ajayi
Scientific

Department of Epidemiology
Medical Statistics and Environmental Health
College of Medicine
University of Ibadan
Ibadan
PMB 5116
Nigeria

Email	ikeajayi2003@yahoo.com

Study information

Primary study design	Interventional
Study design	Single-centre, single-blind, randomised controlled field study.
Secondary study design	Randomised controlled trial
Scientific title
Study objectives	Malaria is a disease caused by the protozoan plasmodium falciparum. It is still rampant in sub-Saharan Africa and endemic in Nigeria with perennial transmission. It causes febrile illness which could be severe in children accounting for 25% of infant mortality and 8-12% of death under age of five years. Malaria is responsible for 40-60% of out patient consultation. It presents in two clinical types - uncomplicated and severe malaria. Study Domain: Parasitic infection; child care and health education/behaviour change Study hypotheses: 1. There will be no significant difference in the outcome of malaria in children whose mothers or caregivers used treatment protocol to treat malaria at home and those whose mothers did not use the protocol. 2. There will be no significant difference in the correctness of use of chloroquine by mothers who used the treatment protocol and those who did not use the protocol. 3. There will be no significant difference in the correctness of use of chloroquine by trained mothers and mothers who were not trained.
Ethics approval(s)	The joint University of Ibadan/University College Hospital Institutional Ethical Review Board. Date of Approval: 29th June 2000
Health condition(s) or problem(s) studied	Malaria
Intervention	Randomisation of the communities to the intervention and control groups was done by ballots. Interventions carried out at the intervention site: 1. Training of 'mother trainers' and community members about cause, symptoms and signs of the clinical types, treatment and prevention of malaria including referral. 2. Development of a treatment protocol using participatory approach and distribution of the protocol to households. The development of the protocol was done in phases using modified focus group sessions with several community checks at different stages of development. The participants were the 'mother trainers', selected community members, research team and a graphic artist. The treatment protocol consists of treatment guidelines for each of the clinical types of malaria compiled together on a cardboard. The protocol illustrated the presentation of clinical types of malaria, the appropriate steps to take for each type and the correct dose and schedule of treatment of uncomplicated malaria using chloroquine according to the age of the child. The protocol was in cartoon format and the local language was used. Mothers/caregivers in both arms of the study were requested to purchase the chloroquine used for treatment from their regular source which in most instances are the drug hawkers and patent medicine sellers. Control arm of the study: They were passive controls. The communities in the control arm of the study were left to continue their usual treatment practice for malaria in their children. No training or guideline was provided. Duration of intervention: One year
Intervention type	Other
Primary outcome measure(s)	The mothers/caregivers were asked about the treatment given to the child during visits by the research assistants. The mothers/caregivers were asked to record these details in their diary, which was checked on Day 7 from recruitment at the time of collecting Day 7 blood sample for microscopy examination. These data were used to assess the following: 1. Correct use of chloroquine, measured in terms of dose, frequency and duration 2. Timeliness of commencing treatment (commencing treatment within 24 hours of noticing fever in child) 3. Treatment outcome, measured by mean parasite clearance time, fever clearance time, and progression of illness as reported by mothers/caregivers 4. Use of the protocol. Proportion of mothers who referred to the treatment protocol in the treatment of last episode of malaria in children
Key secondary outcome measure(s)	1. Attack rate of malaria over a period of one year 2. Sensitivity and specificity of presumptive diagnosis of malaria by mothers/caregivers
Completion date	30/06/2005

Eligibility

Participant type(s)	Patient
Age group	Child
Upper age limit	10 Years
Sex	All
Target sample size at registration	152
Key inclusion criteria	1. Mothers with children 10 years or less who have febrile illness presumed to be malaria 2. Willingness of mothers to allow their child remain in study for a period of 14 days 3. Mothers who consent to their child having finger prick to collect blood for blood smears
Key exclusion criteria	1. Child with severe illness or requiring parenteral medication 2. Child with other diseases, co-morbid with febrile illness Withdrawal Criteria: 1. Parents of children choosing not to continue with the study 2. Progression of illness in child
Date of first enrolment	16/06/2004
Date of final enrolment	30/06/2005

Locations

Countries of recruitment

Nigeria

Study participating centre

Department of Epidemiology

Ibadan
PMB 5116
Nigeria

Results and Publications

Individual participant data (IPD) Intention to share	No
IPD sharing plan summary	Not provided at time of registration
IPD sharing plan