An Integrated eDiagnosis Approach (IeDA) versus standard IMCI for assessing and managing childhood illness in Burkina Faso: a stepped-wedge cluster randomised trial

Sarrassat, Sophie; Lewis, James J.; Some, Arsene S.; Somda, Serge; Cousens, Simon; Blanchet, Karl

doi:10.1186/s12913-021-06317-3

Table 4 Primary and secondary outcomes

From: An Integrated eDiagnosis Approach (IeDA) versus standard IMCI for assessing and managing childhood illness in Burkina Faso: a stepped-wedge cluster randomised trial

Adherence to clinical assessment	Baseline				Control arm				Intervention arm				Cluster-level mean difference between arms	P-value*
Adherence to clinical assessment	N	%	95%CI		N	%	95%CI		N	%	95%CI		Cluster-level mean difference between arms	P-value*
Overall adherence (13 to 33 tasks)	686	48.0	44.3	51.6	1343	54.3	50.6	58.0	695	79.3	72.7	85.9	29.9	0.002
Adherence to danger signs’ assessment (3 tasks)	686	18.4	12.0	24.9	1343	34.2	25.5	42.9	695	95.2	90.0	99.9	71.2	0.002
Identification of at least one danger sign (proportion of children correctly identified with at least one danger sign)	Baseline				Control arm				Intervention arm				Individual-level difference between arms	P-value**
	N^a	%	95%CI		N^a	%	95%CI		N^a	%	95%CI		Individual-level difference between arms	P-value**
	24	66.7	47.2	81.7	25	56.0	30.8	78.4	16	75.0	50.5	89.8	19.0	0.322
Overall correct classification (proportion of children correctly classified with x given classifications)	Baseline				Control arm				Intervention arm				Cluster-level mean difference between arms	P-value*
	N^b	%	95%CI		N^b	%	95%CI		N^b	%	95%CI		Cluster-level mean difference between arms	P-value*
Accounting for the severity of classifications	609	70.6	63.7	76.7	1049	69.8	66.0	73.4	572	74.7	66.9	81.1	9.1	0.038
Ignoring the severity of the classifications	609	75.0	68.0	81.0	1049	73.1	68.8	77.0	572	78.7	72.9	83.5	10.1	0.004
Overall correct prescription (proportion of children who received at least all the recommended prescriptions)	Baseline				Control arm				Intervention arm				Cluster-level mean difference between arms	P-value*
	N^c	%	95%CI		N^c	%	95%CI		N^c	%	95%CI		Cluster-level mean difference between arms	P-value*
According to the HCWs’ classifications	614	75.7	68.0	82.1	1074	77.8	72.5	82.4	567	77.1	71.6	81.8	−1.1	0.788
According to the validation nurses’ classifications	610	65.3	59.8	70.4	1049	66.1	60.7	71.0	572	68.5	58.8	76.9	6.7	0.226
Overall correct referral/hospitalisation (proportion of children in need of referral/hospitalisation who were actually referred/hospitalised)	Baseline				Control arm				Intervention arm				Individual-level difference between arms	P-value**
	N^d	%	95%CI		N^d	%	95%CI		N^d	%	95%CI		Individual-level difference between arms	P-value**
According to the HCWs’ classifications	35	60.0	47.7	71.1	42	52.4	23.7	79.6	41	61.0	21.5	89.9	8.6	0.509
According to the validation nurses’ classifications	29	55.2	36.0	72.9	32	53.1	36.5	69.1	22	68.2	47.8	83.4	15.1	0.398
Overall correct treatment counselling (proportion of caretakers who received information on home-based prescription)	Baseline				Control arm				Intervention arm				Cluster-level mean difference between arms	P-value*
	N^e	%	95%CI		N^e	%	95%CI		N^e	%	95%CI		Cluster-level mean difference between arms	P-value*
	612	77.3	67.5	84.8	1143	91.5	88.8	93.6	576	87.9	77.9	93.7	−4.1	0.355

* t test on cluster-level summaries & accounting for the stepped wedge design; ** Fisher’s exact test on individual-level data & ignoring clustering
^aNumber of children identified, by the validation nurses, with a given danger sign
^b Number of children classified, by the validation nurses, with x given classification
^cNumber of children classified, by the HCWs or by the validation nurses, with x given classification
^dNumber of children identified, by the HCWs or the validation nurses, with at least one danger sign or a classification requiring referral/hospitalisation
e Number of children who were prescribed, by the HCWs, x given treatment (regardless of the classification)

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