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Table 3 Adherence to test results by CHWs

From: Success or failure of critical steps in community case management of malaria with rapid diagnostic tests: a systematic review

Study Target population Treatment Alternative Adherence overall* Positives treated Negatives treated
CCMm studies
Chanda[23, 33] All ages, care seeking. AL, SP <5 kg Complicated malaria and non-malaria febrile cases were referred to HF. 99.9% 99.3% 0.2%
Chinkhumba[30] >5 years, (history of) fever NS Referral not mentioned. 86.9% 98% 58%
Elmardi[27] NS AS/SP Complicated malaria and non-malaria febrile cases were referred to HF. 70%** NS NS
Ishengoma[28] ≥5 years with (history of) fever AL Referral not specified. 95.8% 98.9% 5.4%
Mubi[24] >3 months, (history of) fever. Exclusion: severe disease AL Referral not specified. 96.8% 99.7% 6.1%
Ndiaye[20]*** Patients of all ages, care seeking. NS CHW: referral of patients <2 months, RDT negatives, severe symptoms, suspected drug adverse events. CMD: referral of all cases excluding uncomplicated malaria cases. 88.6% 92.0% 20.3%
Ndiaye[20]*** Patients of all ages, care seeking. NS CHW: Referral of patients <2 months, RDT negatives, severe symptoms, suspected drug adverse events. 85.6% 90.1% 24.8%
Ndiaye[20]*** Patients of all ages, care seeking. NS CMD: Referral of all cases excluding uncomplicated malaria cases. 93.9% 95.3% 10.4%
iCCM studies
Hamer[17] & Yeboah-Antwi[16] Children 6 months-5 years, fever. AL Children with danger signs were referred to HF. 99.3% 98.5% 0.4%
Mukanga[32] Children <5 (history of) fever no danger signs. AL CHWs also diagnosed and treated pneumonia. No referral mentioned. 97.8% 98.6% 4.8%
Mukanga[34]**** BF: 6–59 months, (history of) fever AL Referral for severe disease and for non-responders at day 3 after CHW visit. 99.0% 100% 4.8%
Mukanga[34]**** Gh: 6–59 months, (history of) fever AA Referral for severe disease and for non-responders at day 3 after CHW visit. 99.5% 100% 3.3%
Mukanga[34]**** Ug: 4–59 months (history of) fever. AL Referral for severe disease and for non-responders at day 3 after CHW visit. 99.0% 99.9% 7.6%
  1. * = correct treatment, ** = percentage of CHWs that relied on RDT results, *** = adherence percentages calculated from study data, **** = CHWs attended review meetings with study team each month discussing non-adherence to diagnostic and treatment algorithm with CHWs, HF = health facility, NS = not specified, AL = artemether – lumefantrine, SP = sulphadoxine-pyrimethamine, AS = artesunate, ACT = artemisinin-based combination therapy (not further specified), BF = Burkina Faso, Gh = Ghana, Ug = Uganda.