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Abstract：
BACKGROUND: The World Health Organization recommended (in 2010) universal testing for suspected malaria, due to some fundamental changes in malaria trends such as the declining incidence of malaria in high-burden countries, the emergence of parasite resistance to anti-malarial drugs especially artemisinin-based combination therapies (ACTs) and the increased availability of diagnostic testing such as the malaria rapid diagnostic test (MRDT). The Nigerian government has long adopted this recommendation and with the support of foreign partners has scaled up the availability of MRDT. However, the malaria/MRDT rate in the communities is still far short of the recommendation. This study aims to evaluate the effectiveness of social group and social group/provider interventions in increasing the demand (use and/or request) for MRDT among community members with fever or malaria-like illness in Ebonyi state, Nigeria.
METHODS: A three-arm, parallel, stratified cluster randomized design will be used to evaluate the effect of two interventions compared to control: control involves the usual practice of provision of MRDT services by public primary healthcare providers and patent medicine vendors; social group intervention involves the sensitization/education of social groups about MRDT; social group/provider intervention involves social group treatment plus the training of healthcare providers in health communication about MRDT with clients. The primary outcome is the proportion of children under 5 years of age with fever/malaria-like illness, in the 2 weeks preceding a household survey, who received MRDT. The co-primary outcome is the proportion of children ages 5 years and above and adults (excluding pregnant women) with fever/malaria-like illness, in the 2 weeks preceding a household survey, who received MRDT. The primary outcome will be assessed through household surveys at baseline and at the end of the study.
CONCLUSIONS: The pragmatic and behavioural nature of the interventions delivered to groups of individuals and the need to minimize contamination informed the use of a cluster-randomized design in this study in investigating whether the social group and social group/provider interventions will increase the demand for MRDT among community members. \"Pragmatic\" means the interventions would occur in natural settings or real- life situations.
BACKGROUND: ISRCTN, ISRCTN14046444 . Registered on 14 August 2018.
METHODS: A three-arm, parallel, stratified cluster randomized design will be used to evaluate the effect of two interventions compared to control: control involves the usual practice of provision of MRDT services by public primary healthcare providers and patent medicine vendors; social group intervention involves the sensitization/education of social groups about MRDT; social group/provider intervention involves social group treatment plus the training of healthcare providers in health communication about MRDT with clients. The primary outcome is the proportion of children under 5 years of age with fever/malaria-like illness, in the 2 weeks preceding a household survey, who received MRDT. The co-primary outcome is the proportion of children ages 5 years and above and adults (excluding pregnant women) with fever/malaria-like illness, in the 2 weeks preceding a household survey, who received MRDT. The primary outcome will be assessed through household surveys at baseline and at the end of the study.
CONCLUSIONS: The pragmatic and behavioural nature of the interventions delivered to groups of individuals and the need to minimize contamination informed the use of a cluster-randomized design in this study in investigating whether the social group and social group/provider interventions will increase the demand for MRDT among community members. \"Pragmatic\" means the interventions would occur in natural settings or real- life situations.
BACKGROUND: ISRCTN, ISRCTN14046444 . Registered on 14 August 2018.
摘要：
背景：世界卫生组织（2010年）建议对疑似疟疾进行普遍检测，由于疟疾趋势的一些根本性变化，例如高负担国家的疟疾发病率下降，抗疟疾药物，特别是青蒿素为基础的联合疗法（ACTs）的寄生虫耐药性的出现，以及疟疾快速诊断测试（MRDT）等诊断测试的可用性增加。尼日利亚政府长期以来一直采纳这一建议，并在外国合作伙伴的支持下扩大了MRDT的可用性。然而,社区的疟疾/MRDT比率仍然远远低于建议。本研究旨在评估社会群体和社会群体/提供者干预措施在增加Ebonyi州发烧或疟疾样疾病社区成员对MRDT的需求（使用和/或要求）方面的有效性。尼日利亚。
方法：三臂，平行,与对照相比，将使用分层集群随机设计来评估两种干预措施的效果：对照涉及公共初级医疗保健提供者和专利药物供应商提供MRDT服务的常规做法；社会团体干预涉及对社会团体进行MRDT的敏感性/教育；社会团体/提供者干预涉及社会团体治疗以及对医疗保健提供者与客户进行MRDT健康沟通的培训。主要结果是5岁以下儿童患有发烧/疟疾样疾病的比例，在家庭调查前的两周，接受MRDT的人。共同主要结果是5岁及以上的儿童和患有发烧/疟疾样疾病的成年人（不包括孕妇）的比例，在家庭调查前的两周，接受MRDT的人。主要结果将在基线和研究结束时通过家庭调查进行评估。
结论：对个体群体的干预措施的实际和行为性质，以及减少污染的需要，在本研究中使用集群随机设计来调查社会群体和社会群体/提供者干预措施是否会增加社区成员对MRDT的需求。“务实”是指干预将发生在自然环境或现实生活中。
背景：ISRCTN，ISRCTN14046444。2018年8月14日注册
方法：三臂，平行,与对照相比，将使用分层集群随机设计来评估两种干预措施的效果：对照涉及公共初级医疗保健提供者和专利药物供应商提供MRDT服务的常规做法；社会团体干预涉及对社会团体进行MRDT的敏感性/教育；社会团体/提供者干预涉及社会团体治疗以及对医疗保健提供者与客户进行MRDT健康沟通的培训。主要结果是5岁以下儿童患有发烧/疟疾样疾病的比例，在家庭调查前的两周，接受MRDT的人。共同主要结果是5岁及以上的儿童和患有发烧/疟疾样疾病的成年人（不包括孕妇）的比例，在家庭调查前的两周，接受MRDT的人。主要结果将在基线和研究结束时通过家庭调查进行评估。
结论：对个体群体的干预措施的实际和行为性质，以及减少污染的需要，在本研究中使用集群随机设计来调查社会群体和社会群体/提供者干预措施是否会增加社区成员对MRDT的需求。“务实”是指干预将发生在自然环境或现实生活中。
背景：ISRCTN，ISRCTN14046444。2018年8月14日注册
