{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T18:11:43Z","timestamp":1774721503941,"version":"3.50.1"},"reference-count":24,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["R01AI110478"],"award-info":[{"award-number":["R01AI110478"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,1,12]]},"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There are concerns of inappropriate use of subsidised antimalarials due to the large number of fevers treated in the informal sector with minimal access to diagnostic testing. Targeting antimalarial subsidies to confirmed malaria cases can lead to appropriate, effective therapy. There is evidence that community health volunteers (CHVs) can be trained to safely and correctly use rapid diagnostic tests (RDTs). This study seeks to evaluate the public health impact of targeted antimalarial subsidies delivered through a partnership between CHVs and the private retail sector.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We are conducting a stratified cluster-randomised controlled trial in Western Kenya where 32 community units were randomly assigned to the intervention or control (usual care) arm. In the intervention arm, CHVs offer free RDT testing to febrile individuals and, conditional on a positive test result, a voucher to purchase a WHO-qualified artemisinin combination therapy (ACT) at a reduced fixed price in the retail sector.<\/jats:p>\n                    <jats:p>Study outcomes in individuals with a febrile illness in the previous 4\u2005weeks will be ascertained through population-based cross-sectional household surveys at four time points: baseline, 6, 12 and 18\u2005months postbaseline. The primary outcome is the proportion of fevers that receives a malaria test from any source (CHV or health facility). The main secondary outcome is the proportion of ACTs used by people with a malaria-positive test. Other secondary outcomes include: the proportion of ACTs used by people without a test and adherence to test results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The protocol has been approved by the National Institutes of Health, the Moi University School of Medicine Institutional Research and Ethics Committee and the Duke University Medical Center Institutional Review Board. Findings will be reported on clinicalstrials.gov, in peer-reviewed publications and through stakeholder meetings including those with the Kenyan Ministry of Health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      Pre-results,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02461628\">NCT02461628<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013972","type":"journal-article","created":{"date-parts":[[2017,3,20]],"date-time":"2017-03-20T20:30:21Z","timestamp":1490041821000},"page":"e013972","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Innovative public\u2013private partnership to target subsidised antimalarials: a study protocol for a cluster randomised controlled trial to evaluate a community intervention in Western Kenya"],"prefix":"10.1136","volume":"7","clinical-trial-number":[{"clinical-trial-number":"nct02461628","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02461628","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Jeremiah","family":"Laktabai","sequence":"first","affiliation":[{"name":"Moi School of Medicine, Eldoret, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriane","family":"Lesser","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyssa","family":"Platt","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina, USA"},{"name":"Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Maffioli","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina, USA"},{"name":"Department of Economics, Duke University, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manoj","family":"Mohanan","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina, USA"},{"name":"Department of Economics, Duke University, Durham, North Carolina, USA"},{"name":"Sanford School of Public Policy, Duke University, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Menya","sequence":"additional","affiliation":[{"name":"Moi University School of Public Health, College of Health Sciences, Eldoret, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy","family":"Prudhomme O'Meara","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina, USA"},{"name":"Moi University School of Public Health, College of Health Sciences, Eldoret, Kenya"},{"name":"Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth L","family":"Turner","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina, USA"},{"name":"Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,3,20]]},"reference":[{"key":"2025121510393471000_7.3.e013972.1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-6-57"},{"key":"2025121510393471000_7.3.e013972.2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-2276.2003.01140.x"},{"key":"2025121510393471000_7.3.e013972.3","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-8-243"},{"key":"2025121510393471000_7.3.e013972.4","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-5-60"},{"key":"2025121510393471000_7.3.e013972.5","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-10-327"},{"key":"2025121510393471000_7.3.e013972.6","unstructured":"World Health Organization. World Malaria Report. Geneva, 2012(a)."},{"key":"2025121510393471000_7.3.e013972.7","unstructured":"World Health Organization. Q&A on the Affordable Medicines Facility malaria (AMFm) Secondary Q&A on the Affordable Medicines Facility malaria (AMFm). 2012(b). http:\/\/www.who.int\/malaria\/media\/affordable_medicines_facility_qa\/en\/"},{"key":"2025121510393471000_7.3.e013972.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61732-2"},{"key":"2025121510393471000_7.3.e013972.9","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1111\/j.1365-3156.2011.02918.x","article-title":"Malaria prevalence and treatment of febrile patients at health facilities and medicine retailers in Cameroon","volume":"17","author":"Mangham","year":"2012","journal-title":"Trop Med Int Health"},{"key":"2025121510393471000_7.3.e013972.10","doi-asserted-by":"publisher","DOI":"10.1257\/aer.20130267"},{"key":"2025121510393471000_7.3.e013972.11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0094074"},{"key":"2025121510393471000_7.3.e013972.12","unstructured":"ACTwatch PSIa. Kenya Outlet Survey Findings 2010\u20132014. ACTwatch Research Brief. Washington DC, USA: ACTwatch Research Brief, 2015."},{"key":"2025121510393471000_7.3.e013972.13","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1186\/s12936-016-1404-5","article-title":"A cross-sectional study of the availability and price of anti-malarial medicines and malaria rapid diagnostic tests in private sector retail drug outlets in rural Western Kenya, 2013","volume":"15","author":"Kioko","year":"2016","journal-title":"Malar J"},{"key":"2025121510393471000_7.3.e013972.14","doi-asserted-by":"publisher","DOI":"10.1179\/1364859411Y.0000000042"},{"key":"2025121510393471000_7.3.e013972.15","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-10-158"},{"key":"2025121510393471000_7.3.e013972.16","unstructured":"Republic of Kenya Ministry of Health. Community Strategy Implementation Guidelines for Managers of the Kenya Essential Package for Health at the Community Level. 2007. https:\/\/www.slideshare.net\/chskenya\/community-health-strategyimplementationguide2007"},{"key":"2025121510393471000_7.3.e013972.17","unstructured":"Murray DM . Design and analysis of group-randomized trials. Oxford, UK: Oxford University Press, 1998."},{"key":"2025121510393471000_7.3.e013972.18","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2016-000101"},{"key":"2025121510393471000_7.3.e013972.19","doi-asserted-by":"crossref","unstructured":"Abba K , Deeks JJ , Olliaro P , et al . Rapid diagnostic tests for diagnosing uncomplicated P. falciparum malaria in endemic countries. Cochrane Database Syst Rev 2011;(7):Cd008122. doi:10.1002\/14651858.CD008122.pub2","DOI":"10.1002\/14651858.CD008122.pub2"},{"key":"2025121510393471000_7.3.e013972.20","unstructured":"World Health Organization. Training module on malaria control: case management. Malta: World Health Organization, 2012(c)."},{"key":"2025121510393471000_7.3.e013972.21","unstructured":"Republic of Kenya Ministry of Health. National guidelines for the diagnosis, treatment and prevention of malaria in Kenya. 4th edn, 2014."},{"key":"2025121510393471000_7.3.e013972.22","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.86.5.726"},{"key":"2025121510393471000_7.3.e013972.23","doi-asserted-by":"crossref","unstructured":"Hayes RJ , Moulton LH . Cluster randomised trials. Boca Raton, FL: CRC Press, 2009.","DOI":"10.1201\/9781584888178"},{"key":"2025121510393471000_7.3.e013972.24","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1214\/aos\/1013699998","article-title":"The control of the false discovery rate in multiple testing under dependency","volume":"29","author":"Benjamini","year":"2001","journal-title":"The Ann Stat"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2016-013972","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T18:39:44Z","timestamp":1765823984000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2016-013972"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":24,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2017,3,20]]},"published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1136\/bmjopen-2016-013972"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2016-013972","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3]]}}}