Table 2. Study characteristics.
| Study Design | Study characteristics | Supporting interventions | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| # | First author, Country, Year published | Year performed, Length of study | Type of study | Endemicity level*(Low = <5%, Medium =, 5<x<40% High = >40%) | Urban/ Rural | Type and number of outlets included in intervention arm(s) | Sharp box and/or gloves provided, free of cost? | Length and content of provider training | Guidelines for patients that test negative | Supervision frequency and method | Demand generation activities | Were RDTs subsidized? What was Recommended Retail Price RDT |
| 1 | Allan, Liberia, Unpublished data | 2012–2014, 27 months | Implementation trial | Medium | Urban | Registered medicine store (89), Pharmacy (18) | Yes, both | 3 days, Content based on MoH approved 'Training Manual for Malaria Case Management in the Private Sector: Pharmacies and Medicine Stores'. Sessions included RDT practice and role play | Refer RDT negative patients to public facility | Monthly, direct observation with a checklist by study team At the beginning of every month, a second visit was performed by the supervisors to collect ledger data with tests performed and treatment sold. | 40 community volunteer health promotors promoted malaria testing and treatment at the PMRs and through household visits. Mass awareness activities (2 hours of dance, music, theater and games) | Yes, US$0.26 |
| 2 | Ansah, Ghana,2015 | 2011–2013, 17 months | Randomized Control Trial | High | Rural / peri-urban | Chemical shop (27) | Yes, only sharp box | 4 days, Covered malaria symptoms, antimalarial treatment policy, taking blood smears, safety, and RDT use | Refer RDT negative patients to public facility | Weekly (for the first month, then another visit midway through trial). Direct observation with a checklist by study team | Community sensitization meetings using short films showing patients going into a chemical shop and complaining of fever and provider performing the RDT. | Yes, offered to patients for free |
| 3 | Aung, Myanmar, 2015 | 2013, 18 months | Randomized Control Trial | High | Rural | General retail stores (398); itinerant drug vendors (177); medical drug representatives (56) | 0.5 days, Covered RDT procedure (demonstration with performing RDTs), safety, result reading and interpretation, follow up treatment | Refer RDT negative patients to public facility | Monthly or every 2 weeks depending on intervention arm. Direct observation by medical detailers using check list | No demand generation activities | Yes, US$0.38 | |
| 4 | Awor, Uganda, 2014, 2015 | 2011–2012, 9 months | Non-randomized controlled trial | High | Rural | Drug shops (40) | No | 5 days, Covered integrated Community Case Management and use of RDTs | iCCM | Daily, direct observation and feedback by study nurse present during opening hours | Communication campaign through shop branding, provision of information to caretakers and community | Yes, offered to patients for free |
| 5 | Cohen, Uganda, 2012, 2015 | 2011–2012, 12 months | Implementation trial | High | Peri-urban, rural | Drug stores (92) | Yes, both | 2 days, Covered malaria symptoms, first-line antimalarial treatment, and RDTs (but no specific treatment algorithms) | No guidelines were provided as to how to manage RDT negative patients provided by research team | Monthly, direct observation by study team using checklist | Behavioral Change Campaign (BCC) campaign rolled out by a third party at the end of the study period | Yes, but no RRP was provided |
| 6 | Maloney, Tanzania, Under review | 2013–2014, 12 months | Non-randomized controlled trial | Medium | Rural | Accredited Drug Dispensing Outlets (310) | Yes, both. Note, gloves were added to RDT box by RDT manufac-turer | 2 days, Trainings covered signs and symptoms of uncomplicated and severe malaria, stocking, use, and disposal of RDTs, and appropriate case management based on RDT results. | Refer customers with signs or symptoms of severe illness and suspected malaria patients who tested negative or whose illness did not improve within 48 hours | Quarterly, direct observation by research team using check list | Study coincided with national radio and television campaign promoting RDT use prior to providing treatment | Yes, in one arm of the study, RRP US$0.31, In the other arm, RDTs were not subsidized, RRP of US$0.67 |
| 7 | Mbonye, Uganda, 2015 | 2010–2011, 14 months | Randomized Control Trial | High | Peri-urban and rural | Class C drug shops (29) | Yes, both | 4 days, Covered malaria symptoms, treatment with ACT and rectal artesunate, management of stocks and records, and RDTs, referral policy | Refer RDT negative patients to public facility | Weekly (for first 2 months), direct observation by research team using check list. After 2 months scaled-down to support of providers experiencing difficulties | Community sensitization on diagnostic testing and roadside signage for drug shops with RDTs | Yes, fixed price of US$0.2 |
| 8 | Onwujekwe, Nigeria, 2015 | 2012, 6 months | Randomized Control Trial | High | Urban, peri-urban, and rural | Patent Medicine Vendors (44) and pharmacy shops (71) | Yes, both | 1 day (In basic RDT intervention arm) 2 day (In provider and school-based RDT intervention arms), Covered safe use of RDTs (all arms), plus additional interactive training on malaria diagnosis and treatment for provider and school-based intervention arms | Refer RDT negative patients to public facility | Monthly or quarterly (depending on intervention arm), Quarterly visits in the basic RDT intervention arm; monthly visits in the provider and school-based RDT intervention arms by study team using checklists | In school-based intervention arm, teachers were trained on malaria diagnosis and treatment and expected to train students, provide peer educators and conduct community awareness activities | Yes, US$0.6 |
| 9 | Poyer, Kenya, Unpublished data | 2014–2016, 24 months | Implementation trial | Medium | Urban | Pharmacies (44) | Yes, both | 3 days, Covered malaria epidemiology, testing methods with emphasis on RDT treatment guidelines, commodity management and documentation and reporting. | Abbreviated version of iCCM | Quarterly (based on performance), direct observation using a checklist that assigned score to each outlet (based on assessment of danger signs, RDT procedure, provision of treatment and counseling of patient) used to determine the timing of the next visit. | Small group communication sessions and household visits. National media campaign promoting the use of RDTs | No, US$1.17 |
| 10 | Streat, Nigeria, Unpublished data | 2015–2016, 19 months | Implementation trial | Low/ Medium | Urban and rural | Clinics and pharmacies and Proprietary Patent Medicine Vendors (PPMVs) (350 at start of study, 898 at the end of the study), | Yes, only sharp box | 2 days, e learning covering 'Why testing', Febrile case management, RDT procedure and interpretation, Inter Personal Communications (IPC) skills, waste management, storage of RDTs and training of supervisors, inventory skills, reporting and documentation | Refer to public facility when no capacity to treat | Quarterly, direct observation by representatives of professional associations. In addition, a mobile app was used to collect data on stocks and sales of RDTs | Mass media: TV and radio campaigns | Yes, US$1.25 |
| 11 | Streat, Uganda, Unpublished data | 2014–2016, 21 months | Implementation trial | Low/ Medium | Urban and rural | Clinics and pharmacies (and drug shops (150 at start of study, 1502 at the end of the study) | Yes, only sharp box | 2 days, e learning covering 'Why testing', Febrile case management, RDT procedure and interpretation, IPC skills, waste management, storage of RDTs and training of supervisors, inventory skills, reporting and documentation | Refer to public facility when no capacity to treat | Quarterly, direct observation by representatives of professional associations. In addition, a mobile app was used to collect data on individual case data and stocks and sales of RDTs | Roadshows, promotions, mass media TV billboards radio | Yes, US$1 |
| 12 | Streat, Zambia, Unpublished data | 2010–2011, 12 | Implementation trial | Medium | Urban and rural | Drug shops (63), pharmacies and grocery stores (40) | Yes, both | 3 days, Covered malaria epidemiology, RDT procedure and interpretation treatment of positive cases and referral guidelines, commodity management and documentation and reporting, business skills | Refer RDT negative patients to public facility | Monthly, direct observation by field supervisors for competency and monthly for stock management | Radio messages with shop name mentioned, launch event (including media coverage), Community meetings | Yes, fixed price of US$0.22 |
* Endemicity is measured as the percent of people in a community who are infected with malaria parasites at a given point in time. The classification is based on Malaria ATLAS project (http://www.map.ox.ac.uk/explore/about-malaria/malaria-endemicity/)