Trial design
malaria, diarrhoea, fever
MALARIA
From 1 February 2015, to 20 September 2016, a cluster randomised trial was conducted to measure the causal effect of the intervention on the reduction of diarrhoea and high fever among children (ISRCTN49236178). Our study area covered 40 communities in the Ketu South district in the Volta region of Ghana. The study population was 24,765 people from 4,953 households. Systematic sampling was applied to select study participants in the clusters (communities). The data collectors visited households in each community using the interval method, in which the total number of households in a community is divided by the cluster size. They started by visiting a household located nearest to the main road, from which they continued to visit the next nth household based on the interval (e.g. the next fifth household if the interval was 5). They asked any household members if they had at least one under-5 child. If the household did not meet the eligibility criterion, the household was excluded, and the data collectors continued visiting the next nth one.The primary outcomes of the trial were the period prevalence (proxy measurement of cumulative incidence) of diarrhoea and high fever (proxy measurement of malaria) among children under 5 years of age. Data were collected by conducting a longitudinal panel survey three times (at 0, 6 and 12 months). We adopted a phase-in design in which CHVs were first activated for 20 communities in the intervention group, and CHVs were activated for 20 communities in the control group after the end-line survey was completed. Details of the trial design are provided in the study protocol of the supplementary material #2.