Publications

" Our main objective is to develop and maintain over time a good expertise and infrastructure ensuring high quality training and clinical research."
Prof Halidou TINTO, PharmD, Msc, PhD Head of the CRUN

2024
Journal Articles
	Francois Kiemde, Juvenal Nkeramahame, Ana Belen Ibarz, Sabine Dittrich, Piero Olliaro, Daniel Valia, Toussaint Rouamba, Berenger Kabore, Alima Nadine Kone, Seydou Sawadogo, Antonia Windkouni Bere, Diane Yirgnur Some, Athanase Mwinessobaonfou Some, Adelaide Compaore, Philip Horgan, Stephan Weber, Thomas Keller, Halidou Tinto Impact of a package of point-of-care diagnostic tests, a clinical diagnostic algorithm and adherence training on antibiotic prescriptions for the management of non-severe acute febrile illness in primary health facilities during the COVID-19 pandemic in Burkina Faso Journal Article In: BMC infectious diseases, vol. 24, iss. 1, 2024, ISSN: 1471-2334. Abstract \| BibTeX \| Tags: Adolescent, Adult, Algorithms, Anti-Bacterial Agents / therapeutic use, Burkina Faso, Child, COVID-19* / diagnosis, doi:10.1186/s12879-024-09787-y, Female, Fever* / drug therapy, Francois Kiemde, Halidou Tinto, Humans, Infant, Juvenal Nkeramahame, Male, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11351252, pmid:39192209, Point-of-Care Systems, Point-of-Care Testing, Preschool, Primary Health Care, PubMed Abstract, Randomized controlled trial, SARS-Cov-2 \| Links: Close Close @article{Kiemde2024, title = {Impact of a package of point-of-care diagnostic tests, a clinical diagnostic algorithm and adherence training on antibiotic prescriptions for the management of non-severe acute febrile illness in primary health facilities during the COVID-19 pandemic in Burkina Faso}, author = {Francois Kiemde and Juvenal Nkeramahame and Ana Belen Ibarz and Sabine Dittrich and Piero Olliaro and Daniel Valia and Toussaint Rouamba and Berenger Kabore and Alima Nadine Kone and Seydou Sawadogo and Antonia Windkouni Bere and Diane Yirgnur Some and Athanase Mwinessobaonfou Some and Adelaide Compaore and Philip Horgan and Stephan Weber and Thomas Keller and Halidou Tinto}, url = {https://pubmed.ncbi.nlm.nih.gov/39192209/}, doi = {10.1186/S12879-024-09787-Y}, issn = {1471-2334}, year = {2024}, date = {2024-01-01}, journal = {BMC infectious diseases}, volume = {24}, issue = {1}, publisher = {BMC Infect Dis}, abstract = {Objective: To assess the impact of an intervention package on the prescription of antibiotic and subsequently the rate of clinical recovery for non-severe acute febrile illnesses at primary health centers. Methods: Patients over 6 months of age presenting to primary health care centres with fever or history of fever within the past 7 days were randomized to receive either the intervention package constituted of point-of-care tests including COVID-19 antigen tests, a diagnostic algorithm and training and communication packages, or the standard practice. The primary outcomes were antibiotic prescriptions at Day 0 (D0) and the clinical recovery at Day 7 (D7). Secondary outcomes were non-adherence of participants and parents/caregivers to prescriptions, health workers’ non-adherence to the algorithm, and the safety of the intervention. Results: A total of 1098 patients were enrolled. 551 (50.2%) were randomized to receive the intervention versus 547 (49.8%) received standard care. 1054 (96.0%) completed follow-up and all of them recovered at D7 in both arms. The proportion of patients with antibiotic prescriptions at D0 were 33.2% (183/551) in the intervention arm versus 58.1% (318/547) under standard care, risk difference (RD) -24.9 (95% CI -30.6 to -19.2, p \< 0.001), corresponding to one more antibiotic saved every four (95% CI: 3 to 5) consultations. This reduction was also statistically significant in children from 6 to 59 months (RD -34.5; 95% CI -41.7 to -27.3; p \< 0.001), patients over 18 years (RD -35.9; 95%CI -58.5 to -13.4; p = 0.002), patients with negative malaria test (RD -46.9; 95% CI -53.9 to -39.8; p \< 0.001), those with a respiratory diagnosis (RD -48.9; 95% CI -56.9 to -41.0, p \< 0.001) and those not vaccinated against COVID-19 (-24.8% 95%CI -30.7 to -18.9, p-value: \<0.001). A significant reduction in non-adherence to prescription by patients was reported (RD -7.1; 95% CI -10.9 to -3.3; p \< 0.001). Conclusion: The intervention was associated with significant reductions of antibiotic prescriptions and non-adherence, chiefly among patients with non-malaria fever, those with respiratory symptoms and children below 5 years of age. The addition of COVID-19 testing did not have a major impact on antibiotic use at primary health centers. Trial registration: Clinitrial.gov; NCT04081051 registered on 06/09/2019.}, keywords = {Adolescent, Adult, Algorithms, Anti-Bacterial Agents* / therapeutic use, Burkina Faso, Child, COVID-19* / diagnosis, doi:10.1186/s12879-024-09787-y, Female, Fever* / drug therapy, Francois Kiemde, Halidou Tinto, Humans, Infant, Juvenal Nkeramahame, Male, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11351252, pmid:39192209, Point-of-Care Systems, Point-of-Care Testing, Preschool, Primary Health Care*, PubMed Abstract, Randomized controlled trial, SARS-Cov-2}, pubstate = {published}, tppubtype = {article} } Close Objective: To assess the impact of an intervention package on the prescription of antibiotic and subsequently the rate of clinical recovery for non-severe acute febrile illnesses at primary health centers. Methods: Patients over 6 months of age presenting to primary health care centres with fever or history of fever within the past 7 days were randomized to receive either the intervention package constituted of point-of-care tests including COVID-19 antigen tests, a diagnostic algorithm and training and communication packages, or the standard practice. The primary outcomes were antibiotic prescriptions at Day 0 (D0) and the clinical recovery at Day 7 (D7). Secondary outcomes were non-adherence of participants and parents/caregivers to prescriptions, health workers’ non-adherence to the algorithm, and the safety of the intervention. Results: A total of 1098 patients were enrolled. 551 (50.2%) were randomized to receive the intervention versus 547 (49.8%) received standard care. 1054 (96.0%) completed follow-up and all of them recovered at D7 in both arms. The proportion of patients with antibiotic prescriptions at D0 were 33.2% (183/551) in the intervention arm versus 58.1% (318/547) under standard care, risk difference (RD) -24.9 (95% CI -30.6 to -19.2, p < 0.001), corresponding to one more antibiotic saved every four (95% CI: 3 to 5) consultations. This reduction was also statistically significant in children from 6 to 59 months (RD -34.5; 95% CI -41.7 to -27.3; p < 0.001), patients over 18 years (RD -35.9; 95%CI -58.5 to -13.4; p = 0.002), patients with negative malaria test (RD -46.9; 95% CI -53.9 to -39.8; p < 0.001), those with a respiratory diagnosis (RD -48.9; 95% CI -56.9 to -41.0, p < 0.001) and those not vaccinated against COVID-19 (-24.8% 95%CI -30.7 to -18.9, p-value: <0.001). A significant reduction in non-adherence to prescription by patients was reported (RD -7.1; 95% CI -10.9 to -3.3; p < 0.001). Conclusion: The intervention was associated with significant reductions of antibiotic prescriptions and non-adherence, chiefly among patients with non-malaria fever, those with respiratory symptoms and children below 5 years of age. The addition of COVID-19 testing did not have a major impact on antibiotic use at primary health centers. Trial registration: Clinitrial.gov; NCT04081051 registered on 06/09/2019. Close
	Daniel Valia, Brecht Ingelbeen, Guétawendé Job Wilfried Nassa, Bérenger Kaboré, François Kiemdé, Toussaint Rouamba, Adélaïde Compaoré, Juste Stéphane Kouanda, Annie Robert, Hector Rodriguez-Villalobos, Marianne A B Van Der Sande, Halidou Tinto Antibiotic use by clinical presentation across all healthcare providers in rural Burkina Faso: a healthcare visit exit survey Journal Article In: The Journal of antimicrobial chemotherapy, vol. 79, iss. 10, 2024, ISSN: 1460-2091. Abstract \| BibTeX \| Tags: Adolescent, Adult, Anti-Bacterial Agents* / therapeutic use, Antimicrobial Stewardship* / statistics & numerical data, Brecht Ingelbeen, Burkina Faso, Daniel Valia, doi:10.1093/jac/dkae252, Drug Utilization / statistics & numerical data, Female, Halidou Tinto, Health Personnel* / statistics & numerical data, Humans, Male, MEDLINE, Middle Aged, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11441991, pmid:39051704, PubMed Abstract, Rural Population* / statistics & numerical data, Surveys and Questionnaires, Young Adult \| Links: Close Close @article{Valia2024, title = {Antibiotic use by clinical presentation across all healthcare providers in rural Burkina Faso: a healthcare visit exit survey}, author = {Daniel Valia and Brecht Ingelbeen and Gu\'{e}tawend\'{e} Job Wilfried Nassa and B\'{e}renger Kabor\'{e} and Fran\c{c}ois Kiemd\'{e} and Toussaint Rouamba and Ad\'{e}la\"{i}de Compaor\'{e} and Juste St\'{e}phane Kouanda and Annie Robert and Hector Rodriguez-Villalobos and Marianne A B Van Der Sande and Halidou Tinto}, url = {https://pubmed.ncbi.nlm.nih.gov/39051704/}, doi = {10.1093/JAC/DKAE252}, issn = {1460-2091}, year = {2024}, date = {2024-01-01}, journal = {The Journal of antimicrobial chemotherapy}, volume = {79}, issue = {10}, publisher = {J Antimicrob Chemother}, abstract = {DOI: 10.1093/jac/dkae252; Journal of Antimicrobial Chemotherapy, 00, 0, 2024-07-25.; Abstract: Background: To guide antibiotic stewardship interventions, understanding for what indications antibiotics are used is essential. Methods: In rural Burkina Faso, we measured antibiotic dispensing across all healthcare providers. From October 2021 to February 2022, we surveyed patients in Nanoro district, Burkina Faso, following visits to health centres (3), pharmacies (2), informal medicine vendors (5) and inpatients in health centres. We estimated prevalence of antibiotic use and the proportion of Watch group antibiotics by provider type and by clinical presentation, assessing compliance with WHO’s AWaRe Antibiotic Book. We estimated per capita antibiotic use by multiplying prevalence of antibiotic use, mean DDD per adult treatment course, and the rate of healthcare visits per 1000 inhabitants per day, estimated from a prior household survey. Results: Outpatient antibiotic use was more fre}, keywords = {Adolescent, Adult, Anti-Bacterial Agents* / therapeutic use, Antimicrobial Stewardship* / statistics \& numerical data, Brecht Ingelbeen, Burkina Faso, Daniel Valia, doi:10.1093/jac/dkae252, Drug Utilization / statistics \& numerical data, Female, Halidou Tinto, Health Personnel* / statistics \& numerical data, Humans, Male, MEDLINE, Middle Aged, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11441991, pmid:39051704, PubMed Abstract, Rural Population* / statistics \& numerical data, Surveys and Questionnaires, Young Adult}, pubstate = {published}, tppubtype = {article} } Close DOI: 10.1093/jac/dkae252; Journal of Antimicrobial Chemotherapy, 00, 0, 2024-07-25.; Abstract: Background: To guide antibiotic stewardship interventions, understanding for what indications antibiotics are used is essential. Methods: In rural Burkina Faso, we measured antibiotic dispensing across all healthcare providers. From October 2021 to February 2022, we surveyed patients in Nanoro district, Burkina Faso, following visits to health centres (3), pharmacies (2), informal medicine vendors (5) and inpatients in health centres. We estimated prevalence of antibiotic use and the proportion of Watch group antibiotics by provider type and by clinical presentation, assessing compliance with WHO’s AWaRe Antibiotic Book. We estimated per capita antibiotic use by multiplying prevalence of antibiotic use, mean DDD per adult treatment course, and the rate of healthcare visits per 1000 inhabitants per day, estimated from a prior household survey. Results: Outpatient antibiotic use was more fre Close
2023
Journal Articles
	Daniel Valia, Juste Stéphane Kouanda, Brecht Ingelbeen, Karim Derra, Bérenger Kaboré, François Kiemdé, Toussaint Rouamba, Eli Rouamba, Franck Sovi Hien, Linda Campbell, Marie Meudec, Annie Robert, Halidou Tinto, Marianne A. B. Sande, Hector Rodriguez Villalobos Healthcare seeking outside healthcare facilities and antibiotic dispensing patterns in rural Burkina Faso: A mixed methods study Journal Article In: Tropical medicine & international health : TM & IH, vol. 28, iss. 5, pp. 391-400, 2023, ISSN: 1365-3156. Abstract \| BibTeX \| Tags: Anti-Bacterial Agents* / therapeutic use, Attitude of Health Personnel, Burkina Faso, Child, Daniel Valia, doi:10.1111/tmi.13868, Hector Rodriguez Villalobos, Humans, Juste Stéphane Kouanda, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Patient Acceptance of Health Care, pmid:36871194, Preschool, PubMed Abstract, Research Support, Self Medication \| Links: Close Close @article{Valia2023, title = {Healthcare seeking outside healthcare facilities and antibiotic dispensing patterns in rural Burkina Faso: A mixed methods study}, author = {Daniel Valia and Juste St\'{e}phane Kouanda and Brecht Ingelbeen and Karim Derra and B\'{e}renger Kabor\'{e} and Fran\c{c}ois Kiemd\'{e} and Toussaint Rouamba and Eli Rouamba and Franck Sovi Hien and Linda Campbell and Marie Meudec and Annie Robert and Halidou Tinto and Marianne A. B. Sande and Hector Rodriguez Villalobos}, url = {https://pubmed.ncbi.nlm.nih.gov/36871194/}, doi = {10.1111/TMI.13868}, issn = {1365-3156}, year = {2023}, date = {2023-01-01}, journal = {Tropical medicine \& international health : TM \& IH}, volume = {28}, issue = {5}, pages = {391-400}, publisher = {Trop Med Int Health}, abstract = {Objective: Optimising antibiotic use is important to limit increasing antibiotic resistance. In rural Burkina Faso, over-the-counter dispensing of antibiotics in community pharmacies and non-licensed medicine retail outlets facilitates self-medication. We investigated its extent, reasons and dispensing patterns. Methods: In an exploratory mixed-method design conducted between October 2020 and December 2021, this study first explored illness perceptions, the range of healthcare providers in communities, antibiotics knowledge and reasons for seeking healthcare outside healthcare facilities. Second, frequencies of illness and healthcare utilisation in the last 3 months were quantitatively measured. Results: Participants distinguished between natural and magico-religious illnesses, according to origins. For illnesses considered to be ‘natural’, healthcare was mainly sought at healthcare facilities, private pharmacies and informal drug outlets. For illnesses considered as magico-religious, traditional healers were mainly visited. Antibiotics were perceived in the community as medicines similar to painkillers. Healthcare-seeking outside healthcare facilities was reported by 660/1973 (33.5%) participants reporting symptoms, including 315 (47.7%) to informal vendors. Healthcare seeking outside facilities was less common for 0\textendash4-year-olds (58/534, 10.9% vs. 379/850, 44.1% for ≥5-year-olds) and decreased with improving socio-economic status (108/237, 45.6% in the lowest quintile; 96/418, 23.0% in the highest). Reported reasons included financial limitation, and also proximity to informal drug vendors, long waiting times at healthcare facilities, and health professionals' non-empathetic attitudes towards their patients. Conclusion: This study highlights the need to facilitate and promote access to healthcare facilities through universal health insurance and patient-centred care including reducing patients' waiting time. Furthermore, community-level antibiotic stewardship programmes should include community pharmacies and informal vendors.}, keywords = {Anti-Bacterial Agents / therapeutic use, Attitude of Health Personnel, Burkina Faso, Child, Daniel Valia, doi:10.1111/tmi.13868, Hector Rodriguez Villalobos, Humans, Juste St\'{e}phane Kouanda, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Patient Acceptance of Health Care*, pmid:36871194, Preschool, PubMed Abstract, Research Support, Self Medication}, pubstate = {published}, tppubtype = {article} } Close Objective: Optimising antibiotic use is important to limit increasing antibiotic resistance. In rural Burkina Faso, over-the-counter dispensing of antibiotics in community pharmacies and non-licensed medicine retail outlets facilitates self-medication. We investigated its extent, reasons and dispensing patterns. Methods: In an exploratory mixed-method design conducted between October 2020 and December 2021, this study first explored illness perceptions, the range of healthcare providers in communities, antibiotics knowledge and reasons for seeking healthcare outside healthcare facilities. Second, frequencies of illness and healthcare utilisation in the last 3 months were quantitatively measured. Results: Participants distinguished between natural and magico-religious illnesses, according to origins. For illnesses considered to be ‘natural’, healthcare was mainly sought at healthcare facilities, private pharmacies and informal drug outlets. For illnesses considered as magico-religious, traditional healers were mainly visited. Antibiotics were perceived in the community as medicines similar to painkillers. Healthcare-seeking outside healthcare facilities was reported by 660/1973 (33.5%) participants reporting symptoms, including 315 (47.7%) to informal vendors. Healthcare seeking outside facilities was less common for 0–4-year-olds (58/534, 10.9% vs. 379/850, 44.1% for ≥5-year-olds) and decreased with improving socio-economic status (108/237, 45.6% in the lowest quintile; 96/418, 23.0% in the highest). Reported reasons included financial limitation, and also proximity to informal drug vendors, long waiting times at healthcare facilities, and health professionals' non-empathetic attitudes towards their patients. Conclusion: This study highlights the need to facilitate and promote access to healthcare facilities through universal health insurance and patient-centred care including reducing patients' waiting time. Furthermore, community-level antibiotic stewardship programmes should include community pharmacies and informal vendors. Close
	Francois Kiemde, Daniel Valia, Berenger Kabore, Toussaint Rouamba, Alima Nadine Kone, Seydou Sawadogo, Adelaide Compaore, Olawale Salami, Philip Horgan, Catrin E. Moore, Sabine Dittrich, Juvenal Nkeramahame, Piero Olliaro, Halidou Tinto A Randomized Trial to Assess the Impact of a Package of Diagnostic Tools and Diagnostic Algorithm on Antibiotic Prescriptions for the Management of Febrile Illnesses Among Children and Adolescents in Primary Health Facilities in Burkina Faso Journal Article In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, vol. 77, iss. Suppl 2, pp. S134-S144, 2023, ISSN: 1537-6591. Abstract \| BibTeX \| Tags: Adolescent, Algorithms, Anti-Bacterial Agents* / therapeutic use, Burkina Faso, Child, Daniel Valia, doi:10.1093/cid/ciad331, Francois Kiemde, Halidou Tinto, Health Facilities, Humans, Infant, Malaria* / drug therapy, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC10368409, pmid:37490742, Preschool, Prescriptions, PubMed Abstract, Randomized controlled trial, Research Support \| Links: Close Close @article{Kiemde2023, title = {A Randomized Trial to Assess the Impact of a Package of Diagnostic Tools and Diagnostic Algorithm on Antibiotic Prescriptions for the Management of Febrile Illnesses Among Children and Adolescents in Primary Health Facilities in Burkina Faso}, author = {Francois Kiemde and Daniel Valia and Berenger Kabore and Toussaint Rouamba and Alima Nadine Kone and Seydou Sawadogo and Adelaide Compaore and Olawale Salami and Philip Horgan and Catrin E. Moore and Sabine Dittrich and Juvenal Nkeramahame and Piero Olliaro and Halidou Tinto}, url = {https://pubmed.ncbi.nlm.nih.gov/37490742/}, doi = {10.1093/CID/CIAD331}, issn = {1537-6591}, year = {2023}, date = {2023-01-01}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}, volume = {77}, issue = {Suppl 2}, pages = {S134-S144}, publisher = {Clin Infect Dis}, abstract = {Background: Low- and middle-income countries face significant challenges in differentiating bacterial from viral causes of febrile illnesses, leading to inappropriate use of antibiotics. This trial aimed to evaluate the impact of an intervention package comprising diagnostic tests, a diagnostic algorithm, and a training-and-communication package on antibiotic prescriptions and clinical outcomes. Methods: Patients aged 6 months to 18 years with fever or history of fever within the past 7 days with no focus, or a suspected respiratory tract infection, arriving at 2 health facilities were randomized to either the intervention package or standard practice. The primary outcomes were the proportions of patients who recovered at day 7 (D7) and patients prescribed antibiotics at day 0. Results: Of 1718 patients randomized, 1681 (97.8%; intervention: 844; control: 837) completed follow-up: 99.5% recovered at D7 in the intervention arm versus 100% in standard practice (P =. 135). Antibiotics were prescribed to 40.6% of patients in the intervention group versus 57.5% in the control arm (risk ratio: 29.3%; 95% CI: 21.8-36.0%; risk difference [RD]: -16.8%; 95% CI: -21.7% to -12.0%; P \<. 001), which translates to 1 additional antibiotic prescription saved every 6 (95% CI: 5-8) consultations. This reduction was significant regardless of test results for malaria, but was greater in patients without malaria (RD: -46.0%; -54.7% to -37.4%; P \<. 001), those with a respiratory diagnosis (RD: -38.2%; -43.8% to -32.6%; P \<. 001), and in children 6-59 months old (RD: -20.4%; -26.0% to -14.9%; P \<. 001). Except for the period July-September, the reduction was consistent across the other quarters (P \<. 001). Conclusions: The implementation of the package can reduce inappropriate antibiotic prescription without compromising clinical outcomes. Clinical Trials Registration: clinicaltrials.gov; NCT04081051.}, keywords = {Adolescent, Algorithms, Anti-Bacterial Agents* / therapeutic use, Burkina Faso, Child, Daniel Valia, doi:10.1093/cid/ciad331, Francois Kiemde, Halidou Tinto, Health Facilities, Humans, Infant, Malaria* / drug therapy, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC10368409, pmid:37490742, Preschool, Prescriptions, PubMed Abstract, Randomized controlled trial, Research Support}, pubstate = {published}, tppubtype = {article} } Close Background: Low- and middle-income countries face significant challenges in differentiating bacterial from viral causes of febrile illnesses, leading to inappropriate use of antibiotics. This trial aimed to evaluate the impact of an intervention package comprising diagnostic tests, a diagnostic algorithm, and a training-and-communication package on antibiotic prescriptions and clinical outcomes. Methods: Patients aged 6 months to 18 years with fever or history of fever within the past 7 days with no focus, or a suspected respiratory tract infection, arriving at 2 health facilities were randomized to either the intervention package or standard practice. The primary outcomes were the proportions of patients who recovered at day 7 (D7) and patients prescribed antibiotics at day 0. Results: Of 1718 patients randomized, 1681 (97.8%; intervention: 844; control: 837) completed follow-up: 99.5% recovered at D7 in the intervention arm versus 100% in standard practice (P =. 135). Antibiotics were prescribed to 40.6% of patients in the intervention group versus 57.5% in the control arm (risk ratio: 29.3%; 95% CI: 21.8-36.0%; risk difference [RD]: -16.8%; 95% CI: -21.7% to -12.0%; P <. 001), which translates to 1 additional antibiotic prescription saved every 6 (95% CI: 5-8) consultations. This reduction was significant regardless of test results for malaria, but was greater in patients without malaria (RD: -46.0%; -54.7% to -37.4%; P <. 001), those with a respiratory diagnosis (RD: -38.2%; -43.8% to -32.6%; P <. 001), and in children 6-59 months old (RD: -20.4%; -26.0% to -14.9%; P <. 001). Except for the period July-September, the reduction was consistent across the other quarters (P <. 001). Conclusions: The implementation of the package can reduce inappropriate antibiotic prescription without compromising clinical outcomes. Clinical Trials Registration: clinicaltrials.gov; NCT04081051. Close
	Piero Olliaro, Juvenal Nkeramahame, Philip Horgan, Halidou Tinto, François Kiemde, Rita Baiden, Alexander Adjei, James Kapisi, Heidi Hopkins, Olawale Salami, Catrin E. Moore, Sabine Dittrich, Stephan Weber, Stefano Ongarello Synthesis and Meta-analysis of 3 Randomized Trials Conducted in Burkina Faso, Ghana, and Uganda Comparing the Effects of Point-of-Care Tests and Diagnostic Algorithms Versus Routine Care on Antibiotic Prescriptions and Clinical Outcomes in Ambulatory Patients <18 Years of Age With Acute Febrile Illness Journal Article In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, vol. 77, iss. Suppl 2, pp. S199-S205, 2023, ISSN: 1537-6591. BibTeX \| Tags: {Algorithms, Anti-Bacterial Agents* / therapeutic use, Author(firstnames='Adélaïde', Author(firstnames='Alexander', Author(firstnames='Asadu', Author(firstnames='Daniel', Author(firstnames='David', Author(firstnames='Deborah', Author(firstnames='Elizeus', Author(firstnames='François', Author(firstnames='Freddy Eric', Author(firstnames='Halidou', Author(firstnames='Heidi', Author(firstnames='James', Author(firstnames='Rita', Author(firstnames='Vida', Burkina Faso, CollabAuthor(name='ADIP study group', Diagnostic Tests, Ghana, Humans, Juvenal Nkeramahame, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Piero Olliaro, PMC10368413, Point-of-Care Testing, Prescriptions, PubMed Abstract, Randomized Controlled Trials as Topic, Research Support \| Links: Close Close @article{Olliaro2023, title = {Synthesis and Meta-analysis of 3 Randomized Trials Conducted in Burkina Faso, Ghana, and Uganda Comparing the Effects of Point-of-Care Tests and Diagnostic Algorithms Versus Routine Care on Antibiotic Prescriptions and Clinical Outcomes in Ambulatory Patients \<18 Years of Age With Acute Febrile Illness}, author = {Piero Olliaro and Juvenal Nkeramahame and Philip Horgan and Halidou Tinto and Fran\c{c}ois Kiemde and Rita Baiden and Alexander Adjei and James Kapisi and Heidi Hopkins and Olawale Salami and Catrin E. Moore and Sabine Dittrich and Stephan Weber and Stefano Ongarello}, url = {https://pubmed.ncbi.nlm.nih.gov/37490743/}, doi = {10.1093/CID/CIAD324}, issn = {1537-6591}, year = {2023}, date = {2023-01-01}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}, volume = {77}, issue = {Suppl 2}, pages = {S199-S205}, publisher = {Clin Infect Dis}, keywords = {{Algorithms, Anti-Bacterial Agents / therapeutic use, Author(firstnames='Ad\'{e}la\"{i}de', Author(firstnames='Alexander', Author(firstnames='Asadu', Author(firstnames='Daniel', Author(firstnames='David', Author(firstnames='Deborah', Author(firstnames='Elizeus', Author(firstnames='Fran\c{c}ois', Author(firstnames='Freddy Eric', Author(firstnames='Halidou', Author(firstnames='Heidi', Author(firstnames='James', Author(firstnames='Rita', Author(firstnames='Vida', Burkina Faso, CollabAuthor(name='ADIP study group', Diagnostic Tests, Ghana, Humans, Juvenal Nkeramahame, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Piero Olliaro, PMC10368413, Point-of-Care Testing*, Prescriptions, PubMed Abstract, Randomized Controlled Trials as Topic, Research Support}, pubstate = {published}, tppubtype = {article} } Close
	Adelaïde Compaore, Deborah Ekusai-Sebatta, David Kaawa-Mafigiri, Vida Kukula, Selase Odopey, James Kapisi, Heidi Hopkins, François Kiemde, Halidou Tinto, Rita Baiden, Piero Olliaro, Juvenal Nkeramahame, Sabine Dittrich, Philip Horgan Viewpoint: Antimicrobial Resistance Diagnostics Use Accelerator: Qualitative Research on Adherence to Prescriptions Journal Article In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, vol. 77, iss. Suppl 2, pp. S206-S210, 2023, ISSN: 1537-6591. Abstract \| BibTeX \| Tags: {Adélaïde Compaoré, Anti-Bacterial Agents* / therapeutic use, Author(firstnames='Adélaïde', Author(firstnames='Alexander', Author(firstnames='Asadu', Author(firstnames='Daniel', Author(firstnames='David', Author(firstnames='Deborah', Author(firstnames='Elizeus', Author(firstnames='François', Author(firstnames='Freddy Eric', Author(firstnames='Halidou', Author(firstnames='Heidi', Author(firstnames='James', Author(firstnames='Rita', Author(firstnames='Vida', Bacterial, Clinical Trial, CollabAuthor(name='ADIP study group', Communication, Deborah Ekusai-Sebatta, Drug Resistance, Humans, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC10368411, Prescriptions, PubMed Abstract, Qualitative research, Research Support \| Links: Close Close @article{Compaore2023, title = {Viewpoint: Antimicrobial Resistance Diagnostics Use Accelerator: Qualitative Research on Adherence to Prescriptions}, author = {Adela\"{i}de Compaore and Deborah Ekusai-Sebatta and David Kaawa-Mafigiri and Vida Kukula and Selase Odopey and James Kapisi and Heidi Hopkins and Fran\c{c}ois Kiemde and Halidou Tinto and Rita Baiden and Piero Olliaro and Juvenal Nkeramahame and Sabine Dittrich and Philip Horgan}, url = {https://pubmed.ncbi.nlm.nih.gov/37490738/}, doi = {10.1093/CID/CIAD323}, issn = {1537-6591}, year = {2023}, date = {2023-01-01}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}, volume = {77}, issue = {Suppl 2}, pages = {S206-S210}, publisher = {Clin Infect Dis}, abstract = {In this Viewpoint, the authors explore the determinants of patients' prescription adherence behaviors as part of FIND's Advancing Access to Diagnostic Innovation essential for Universal Health Coverage and AMR Prevention (ADIP) trials (ClinicalTrials.gov identifier: NCT04081051). Research findings from Burkina Faso, Ghana, and Uganda show that basic knowledge and understanding of prescription instructions are essential for adherence and can be improved through better communication. However, there are a range of other factors that influence adherence, some of which can be influenced through tailored communication messages from healthcare workers. These messages may contribute to changes in adherence behavior but may require other reinforcing interventions to be effective. Finally, there are some drivers of nonadherence centered around costs and time pressure that require other forms of intervention.}, keywords = {{Ad\'{e}la\"{i}de Compaor\'{e}, Anti-Bacterial Agents / therapeutic use, Author(firstnames='Ad\'{e}la\"{i}de', Author(firstnames='Alexander', Author(firstnames='Asadu', Author(firstnames='Daniel', Author(firstnames='David', Author(firstnames='Deborah', Author(firstnames='Elizeus', Author(firstnames='Fran\c{c}ois', Author(firstnames='Freddy Eric', Author(firstnames='Halidou', Author(firstnames='Heidi', Author(firstnames='James', Author(firstnames='Rita', Author(firstnames='Vida', Bacterial*, Clinical Trial, CollabAuthor(name='ADIP study group', Communication, Deborah Ekusai-Sebatta, Drug Resistance, Humans, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC10368411, Prescriptions, PubMed Abstract, Qualitative research, Research Support}, pubstate = {published}, tppubtype = {article} } Close In this Viewpoint, the authors explore the determinants of patients' prescription adherence behaviors as part of FIND's Advancing Access to Diagnostic Innovation essential for Universal Health Coverage and AMR Prevention (ADIP) trials (ClinicalTrials.gov identifier: NCT04081051). Research findings from Burkina Faso, Ghana, and Uganda show that basic knowledge and understanding of prescription instructions are essential for adherence and can be improved through better communication. However, there are a range of other factors that influence adherence, some of which can be influenced through tailored communication messages from healthcare workers. These messages may contribute to changes in adherence behavior but may require other reinforcing interventions to be effective. Finally, there are some drivers of nonadherence centered around costs and time pressure that require other forms of intervention. Close