Intervention
fever, ’
The intervention was a package of pathogen-specific and nonpathogen-specific POCTs for common causes of fever in Ghana, a clinical and diagnostic algorithm based on the results of the POCT (Diagnostic algorithm. Study flow chart.The POCTs were selected based on fever etiology in Ghana, local availability, and international approval for fever diagnosis and management. Clinical decision-making on whether or not to prescribe an antibiotic in addition to other treatments was guided by the diagnostic algorithm. When a pathogen-specific bacterial test was positive, an appropriate antibiotic was prescribed following existing guidelines. When the pathogen-specific POCT was negative, the decision to prescribe an antibiotic was based on the C-reactive protein (CRP) and white blood cell (WBC) count results. The T&C was developed based on the findings of the baseline qualitative research conducted to investigate the social, economic, and cultural factors that support or hinder patients’ adherence to antibiotic prescriptions and the communication of adherence messages from healthcare workers in the last quarter of 2019. The qualitative findings guided the development of training material for healthcare workers on adherence and how to communicate issues of adherence to participants in a patient-centered manner guided by participants’ baseline qualitative interviews. These findings have been published as a separate article in this supplement (Kukula et al).