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We sought to determine if this strategy could decrease malaria parasite prevalence in high malaria transmission settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CHWs in the intervention (ProCCM) arm were asked to visit households proactively twice per month to offer an extensive package of maternal and child health services, including malaria case management for males and females of all ages, compared to those in the control arm that offered these services from a fixed point in the community. We measured parasite prevalence among all ages, and fever prevalence, care seeking, and access to diagnostic testing among children under 5\u00a0years at the endline survey of a 3-year cluster-randomized controlled trial of ProCCM, covering a population of over 100,000 in Bankass, Mali, a remote rural area that became a conflict zone during the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was no difference between intervention and control arms in parasite prevalence among all ages, fever in the last 2\u00a0weeks, care seeking, or access to diagnostic testing for malaria among children under 5\u00a0years. However, CHWs in the intervention arm reached the goal of two visits per month in less than half the households.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this high transmission setting, with well-supported, supplied, supervised, and compensated CHWs, both fixed point (control) and proactive household (intervention) visits offered comparable benefits in extending access to malaria case management to community members, despite intervention arm CHWs not reaching the target household visit frequency.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Trial registration<\/jats:italic>\n                      Trial registration number NCT02694055 (registered February 26, 2016).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12936-026-05849-5","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T07:07:22Z","timestamp":1779260842000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of proactive community case management of malaria on malaria prevalence in Bankass, Mali: a cluster-randomised controlled trial"],"prefix":"10.1186","volume":"25","clinical-trial-number":[{"clinical-trial-number":"nct02694055","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Julie","family":"Thwing","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saibou","family":"Doumbia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliou","family":"Traore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahamadou","family":"Sylla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahamadou","family":"Sogoba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idrissa","family":"Kamara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yacouba","family":"Samak\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamine","family":"Guindo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Rapp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Treleaven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calvin","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Whidden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aminatou","family":"Kone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdoulaye A.","family":"Djimde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari D.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kassoum","family":"Kayentao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"5849_CR1","volume-title":"Levels & trends in child mortality: report 2023, estimates developed by the United Nations Inter-agency Group for Child Mortality Estimation","author":"United Nations Inter-agency Group for Child Mortality Estimation (UN IGME)","year":"2024","unstructured":"United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Levels & trends in child mortality: report 2023, estimates developed by the United Nations Inter-agency Group for Child Mortality Estimation. New York: United Nations Children\u2019s Fund; 2024."},{"key":"5849_CR2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012882","volume":"2","author":"NP Oliphant","year":"2021","unstructured":"Oliphant NP, Manda S, Daniels K, Odendaal WA, Besada D, Kinney M, et al. Integrated community case management of childhood illness in low- and middle-income countries. Cochrane Database Syst Rev. 2021;2:CD012882. https:\/\/doi.org\/10.1002\/14651858.CD012882.","journal-title":"Cochrane Database Syst Rev"},{"key":"5849_CR3","volume-title":"WHO guideline on health policy and system support to optimize community health worker programmes","author":"World Health Organization","year":"2018","unstructured":"World Health Organization. WHO guideline on health policy and system support to optimize community health worker programmes. 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If the respondent was a minor, her parent\u2019s or guardian\u2019s consent was obtained. All methods used in the study were performed in accordance with the relevant Malian and US guidelines and regulations. Any individual, regardless of study enrollment status, permanent residency, study arm, or age, who sought health care from study CHWs were eligible to receive care. The ProCCM trial received ethical approval from the ethics committee at the Universit\u00e9 des Sciences, des Techniques et des Technologies of Bamako (USTTB) (Ref: 2016\/03\/CE\/FMPOS). The malaria sub-study was added as a protocol amendment and approved by the ethics committee at USTTB.\u00a0Secondary analysis of trial data, including the malaria sub-study data, was approved by the Observational\/Interventions Research Ethics Committee at the London School of Hygiene & Tropical Medicine (Ref: 13832-1).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}},{"value":"SD, MS, MS, IK, YS, LG, SR, CW, ADJ and KK were employed by Muso at the time of the trial. ET and CC received grants from Muso. All other authors declare that they have no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"261"}}