Table 4. Impact on provider and community knowledge of malaria diagnosis and treatment, by study arm.
| Arm | Clusters | Individual-level prevalence*N (%) | Cluster-level prevalenceMean (SD) | Stratified RD (95% CI) | F-test (p-value) | |
|---|---|---|---|---|---|---|
| PROVIDER KNOWLEDGE | ||||||
| The treatment guidelines † | Control | 12 | 40/74 (54%) | 67% (31%) | 0 | 0.72 |
| Provider | 14 | 57/109 (52%) | 62% (33%) | -5.2% (-33.4, 23.1) | ||
| Provider-school | 13 | 52/74 (70%) | 57% (44%) | -11.5% (-40.2, 17.3) | ||
| Febrile patients should be tested for malaria | Control | 12 | 71/75 (95%) | 95% (8%) | 0 | 0.70 |
| Provider | 14 | 105/109 (96%) | 98% (5%) | 3.1% (-4.5, 10.7) | ||
| Provider-school | 13 | 73/74 (99%) | 96% (14%) | 1.2% (-6.5 9.0) | ||
| How to use an RDT ‡ (mean score, SD) | Control | 12 | 6.4 (3.1) | 6.8 (3.2) | 0 | 0.27 |
| Provider | 14 | 7.9 (3.4) | 7.6 (1.3) | 0.9 (-0.9, 2.6) | ||
| Provider-school | 13 | 9.1 (2.8) | 8.2 (1.8) | 1.4 (-0.3, 3.2) | ||
| How to interpret an RDT result § | Control | 12 | 28/54 (52%) | 57% (38%) | 0 | 0.92 |
| Provider | 14 | 52/90 (58%) | 61% (34%) | 4.1% (-27.2, 35.5) | ||
| Provider-school | 13 | 44/63 (70%) | 63% (44%) | 6.5% (-25.5, 38.4) | ||
| First line treatment recommended by the Government | Control | 12 | 42/68 (62%) | 75% (40%) | 0 | 0.18 |
| Provider | 14 | 85/93 (91%) | 86% (21%) | 10.5% (-10.5, 31.6) | ||
| Provider-school | 13 | 67/74 (91%) | 96% (9%) | 20.1% (-1.3, 41.5) | ||
| ACT given if the malaria test is positive | Control | 12 | 68/70 (97%) | 84% (30%) | 0 | 0.06 |
| Provider | 14 | 104/106 (98%) | 98% (5%) | 13.9% (0.1, 27.6) | ||
| Provider-school | 13 | 73/73 (100%) | 99% (2%) | 15.6% (1.6, 29.6) | ||
| Antimalarial not given if the malaria test is negative | Control | 12 | 56/71 (79%) | 75% (32%) | 0 | 0.60 |
| Provider | 14 | 94/105 (89%) | 83% (24%) | 8.6% (-13.0, 30.3) | ||
| Provider-school | 13 | 59/65 (91%) | 85% (25%) | 10.5% (-11.6, 32.5) | ||
| COMMUNITY KNOWLEDGE | ||||||
| Febrile patients should be tested for malaria ǁ | Control | 12 | 61/85 (72%) | 77% (25%) | 0 | 0.85 |
| Provider | 14 | 94/116 (81%) | 75% (25%) | -2.1% (-22.4, 18.3) | ||
| Provider-school | 14 | 97/115 (84%) | 81% (31%) | 3.5% (-17.2, 24.2) | ||
| First line treatment recommended by the Government | Control | 12 | 50/64 (78%) | 79% (26%) | 0 | 0.53 |
| Provider | 13 | 70/81 (86%) | 88% (18%) | 8.4% (-9.1, 25.8) | ||
| Provider-school | 14 | 112/126 (89%) | 88% (20%) | 8.5% (-8.6, 25.6) | ||
| Were aware of a school or local community malaria event # | Control | 12 | 64 /320 (20%) | 20% (25%) | 0 | 0.002 |
| Provider | 14 | 30 /353 (9%) | 9% (9%) | -10.7% (-29.3, 7.9) | ||
| Provider-school | 14 | 110/288 (38%) | 43% (31%) | 22.5% (3.9, 41.1) | ||
| Attended a school or local community malaria event # | Control | 10 | 52/64 (81%) | 66% (39%) | 0 | 0.17 |
| Provider | 10 | 25/30 (83%) | 86% (30%) | 21.3% (-5.1, 47.6) | ||
| Provider-school | 12 | 89/108 (82%) | 86% (17%) | 21.2% (-4.0, 46.5) |
TABLE NOTES
* Number of providers – 75 in control, 110 in provider and 74 in provider-school. Number of households – 382 in control, 423 in provider, 413 in provider-school.
† Report that parasitological testing is recommended and that ACTs are for confirmed cases of malaria.
‡ Data are mean (SD): based on a score (out of 11) derived from correct identification of several steps taken in the use of an RDT. Steps include: Wear gloves; Write patient's name; Warm patient's finger; Clean patient's finger; Use lancet to prick finger; Dispose of lancet; Use loop to collect blood; Drop blood in well; Dispose of loop; Add buffer; Read results after 10–15 minutes. Sub-set of those who correctly identified that an RDT is used to diagnose malaria
§ Knows how to identify positive, negative, and invalid malaria RDT results
# May or may not be a REACT-initiated malaria event at school (some schools were used to distribute ITNs). Attended an event only asked of those who were aware of malaria activities in the schools or community in past year.
ǁ Among those who reported that they had heard about malaria diagnostic tests or RDTs