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London School of Hygiene & Tropical Medicine Malaria Centre

Malaria clinical trials and studies

ACT PRIME Study: evaluating the impact of enhanced health facility-based care for malaria and febrile illnesses in children in Tororo, Uganda.

LSHTM investigators:
Sarah Staedke & Clare Chandler.
External collaborators:
Moses Kamya & Fred Wabwire- Mangen (Makerere University, Uganda); Grant Dorsey & Philip Rosenthal (University of California, USA); Ambrose Talisuna (WWARN East Africa Centre); Heidi Hopkins (FIND Diagnostics, Uganda).
Funding body:
ACT Consortium, funded through a grant from the Bill & Melinda Gates Foundation to the London School of Hygiene and Tropical Medicine

ACT PRIME is designed to evaluate whether enhancing public health facilities by training health workers and supplementing the supply of malaria drugs and diagnostics improves the health of children, as compared to ‘standard care’ currently available in Tororo, Uganda. 

Twenty lower-level health centres were randomly assigned to the health facility intervention (HFI) or to standard care using a cluster-randomised design.  The HFI has three components: (1) training in-charges in health centre management, (2) training health workers in fever case management and patient-centred services, and (3) ensuring adequate supplies of artemether-lumefantrine and rapid diagnostic tests (RDTs).

To evaluate the impact of the intervention, a cross-sectional survey (CSS) was conducted at baseline in randomly selected children from each cluster, and will be repeated annually.  A cohort of children was recruited from randomly selected households, and will be followed for 2 years.  Health facilities are also assessed using patient exit interviews, health worker knowledge questionnaires, and monthly surveillance.  The primary outcome of the study is prevalence of anaemia in children under five. Formative research was completed in September 2010, and the main trial began in December 2010. The intervention was rolled out in May 2011, and the study will continue until May 2013.