Table 4. Diagnosis and treatment outcomes.
| Study | Outcomes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Percent (Numerator / Denominator) | |||||||||||||
| Author | Country | Description of intervention arm (s) | RDT uptake | RDT positivity | ACTs dispensed | Adherence | Antibiotics provided | Referrals | Safety & Accuracy | Cost | |||
| % of treatment seeking patients receiving RDT | % of patients receiving an RDT who tested positive | % of treatment seeking patients who received an ACT | % of patients with a negative RDT result not receiving ACT or AM | % of patients with a positive RDT result receiving ACT | % of patients not tested receiving ACT or other AM | % of patients with a negative RDT result receiving antibiotic | % of patients with a positive RDT result receiving antibiotic | % of patients referred elsewhere by the provider for further care | % of providers who could accurately perform an RDT, read its result and dispose of waste (at the time of performing the RDT) | (Median retail price to patient in US$) | |||
| Allan | Liberia | Trained provider and subsidized RDTs | 41 (38/92) | 36 (29695/81530) | 36 (33/92) a | 79 (30/38) a | 79 (15/19)a | 74 (40/54) a | 11 (4/38) a | NA | 10 (9/92) | 39 (15/38) | 0.32 |
| Ansah | Ghana | Intervention arm: Trained providers and subsidized RDTs | 100 (2719/2719) | 49.7 (1351/2719) | 47 (1247/2641) | 97 (1330/1368) | 99.5 (1344/1351) | NA | 0.65 (8/1368) | 0 (0/1351) | 40 (1095/2719) | 87.2–100 (116/133)e | Free |
| Control arm: Trained providers but no RDTs | NA | NA | 83 (1632/1962) | NA | NA | NA | NA | NA | 0 1/2029 | NA | NA | ||
| Aung | Myanmar | Arm 1: RDT subsidy and resupply in exchange for used RDTs plus monthly check-in visit | 51 (32/63) a | NA | NA | 80 (28/35)b | NA | NA | NA | NA | NA | 94d (110/116) | NA |
| Arm 2: Price subsidy plus free RDT kit for every five purchased | 64 (35/55) a | NA | NA | 83 (30/36) b | NA | NA | NA | NA | NA | NA | NA | ||
| Arm 3: Price subsidy, bimonthly support and education visits | 59(31/53) a | NA | NA | 87(39/45) b | NA | NA | NA | NA | NA | NA | NA | ||
| Awor | Uganda | Intervention arm: Trained providers in iCCM with malaria RDTs, with provision of drugs | 87.7 (427/497) | 75 | 81 (393/487) | 91 (10/11) | 100 (33/33) | NA | NA | NA | NA | NA | NA |
| Control arm: No iCCM training and provision of ACTs only | NA | NA | 41 (113/275) | NA | NA | NA | NA | NA | NA | NA | NA | ||
| Cohen | Uganda | Trained provider and subsidized RDTs | 17 (478/2235) | 89 (421/475) | 29 (840/2868) | 59 (32/54) | 30 (128/421) | 60 (1414/2362) | 31 (17/54) | 31 (129/441) | NA | 99 (273/275) | 0.4 |
| Maloney | Tanzania | Intervention arm: Trained providers and subsidized RDTs | 66 (143/217) | 41 | 32 (60/185) | 91 (69/76) | 84 (38/45) | 57 (36/63) | 11 (8/76) | 16 (7/45) | NA | 90 (165/184)c | 0.31 |
| Intervention arm: Trained providers and unsubsidized RDTs | 65 (160/247) | 41 | 32 (68/211) | 95 (76/80) | 67 (35/52) | 82 (64/78) | 10 (8/80) | 6 (3/52) | NA | NA | 0.67 | ||
| Control arm: No training or RDTs | N/A | NA | 43 (83/192) | NA | 100 (7/7) | 72 (133/184) | NA | 57 (4/7) | NA | NA | NA | ||
| Mbonye | Uganda | Intervention arm: Trained providers and subsidized RDTs | 97.8 (8480/8672) | 58.5 | 60.8 (4907/8073) | 98.5 (3117/3166) | 99.0 (4858/4907) | NA | 45.1 (51/113) | 23.6 (30/127) | 11.2 (839/7522) | 95 (6931/7270) d | 0.2 |
| Control arm: Trained providers but no RDTs | NA | NA | 99.7 (6781/6797) | NA | NA | 99.7 (6781/6797) | NA | NA | 3.3 (189/5797) | NA | NA | ||
| Onwujekwe | Nigeria | Intervention arm: Demonstration on how to use RDTs and subsidized RDTs | 25 (335/1352) | 75 | 48 (642/1352) | 45 (27/60) | 76 (193/254) | 89 (805/907) | 12 (7/58) | 17 (41/249) | 0.8 (11/1316) | NA | 0.9 |
| Intervention arm: Trained providers and subsidized RDTs | 12 (185/1510) | 33 | 49 (733/1510) | 43 (50/117) | 80 (55/69) | 86 (1121/1307) | 17 (20/116) | 15 (10/68) | 0.8 (12/1502) | NA | 0.9 | ||
| Intervention arm: Trained providers, subsidized RDTs, plus school-based intervention | 8 (109/1292) | 42 | 56 (722/1292) | 17 (8/48) | 71 (43/61) | 90 (1045/1159) | 17 (8/48) | 11 (7/61) | 0.8 (10/1276) | NA | 1.2 | ||
| Poyer | Kenya | Intervention arm: RDTs in pharmacies | 34.2 (41/121) | 47.7 (20/41) | 46.8 (56/120) | 84.8 (17/20) | 84.4 (17/20) | 50.0 (34/69) | 36.4 (7/20) | 18.9 (3/20) | 7.9 (9/120) | NA | 1.14 |
| Streat | Nigeria | Intervention arm: Trained providers and subsidized RDTs | NA | 33 (4812/14619) | NA | 87 (7881/9028) | 88 (4238/481 | NA | NA | NA | NA | 72 (192/268) | 1.5 |
| Streat | Uganda | Intervention arm: Trained providers and subsidized RDTs | 48 (802/1671) | 70 (154/221) | NA | 84 (799/952) | 83 (261/315) | NA | NA | NA | NA | 75 (351/469) | 1 |
| Streat | Zambia | Trained providers and subsidized RDTs | 72 (130/178) | 73 (101/138) | 27 (69/256) | 77 (34/44) a | 87 (88/101) a | 62 (142/228) a | 3 (3/101) | 2 (2/94) a | NA | 90 (29/32) | 0.2 |
a) Based on mystery shopper survey which did not prompt for RDT, ACT or antibiotic
b) Assumes all mystery shoppers were tested RDT negative
c) Reported proportion of health providers reading test accurately separately. Results show similar high scores: 98% (180/184)
d) Waste disposal procedure was not included in the assessment
e) 87.2–100 indicates the range of outcomes for each of the indicators. Out of 133 observations, 116 represent the number of chemical sellers who immediately discarded the sharps into the sharps bin