Completed Infection & Immunity Public Health & Healthcare

South and Southeast Asian Community-based Trials Network: Rural Fever

In plain English

AI plain-English summary

Village health workers across 750 rural communities in South and Southeast Asia will use mobile devices to track more than 100,000 fever cases over three years. Fever is one of the most common reasons people seek medical care in these regions, yet its true causes and outcomes remain poorly documented because many patients never reach a formal clinic or hospital. Without reliable data, health workers cannot tell which fevers are caused by malaria, dengue, bacterial infections, or other treatable conditions, and they lack tools to identify which patients need urgent referral to higher-level facilities. This network will fill that gap by systematically recording every fever episode, taking biological samples for lab analysis, and mapping local health services. The findings will feed into electronic decision-support tools that combine point-of-care diagnostic tests with location-specific risk data, helping village health workers make faster, more accurate treatment decisions. If successful, the infrastructure will later host large-scale trials of new interventions, potentially reducing deaths and severe illness from fevers in some of the world’s most underserved populations.

View original technical description
This Project will establish the Sowth and Southeast Asian Community-based Trials Network (SEACTN), which in the first instance will be used for monitoring the incidence, causes and outcomes of febrile illness in rural communities in the region. The SEACTN infrastructure will be used in later projects for the trialling of interventions delivered by village health workers (VHWs) and rural clinics to improve the management of febrile illness. During the initial three-year funding period the SEACTN infrastructure will be built up across 750 villages in three South and Southeast Asian countries, facilitating the capturing of over 100,000 episodes and outcomes of febrile illness in remote and underserved communities. Key activities include the provision of mobile devices with data collection applications to VHWs and health facility staff for them to record the incidence of patients presenting with febrile illness. They will then be prompted to follow patients up to record the outcomes of the illness episodes. Samples from febrile patients will also be taken for aetiological investigations ·to better understand the causes and spatiotemporal heterogeneity of fever, and to investigate whether host biomarkers of severe illness can predict which patients are most likely to require referral from the community to higher level facilities. Health seeking behaviour surveys will also be carried out, and health facilities and services in the region will be mapped. The findings will provide an unprecedented account of the incidence and associated morbidity and mortality of febrile illness in rural settings in South and Southeast Asia, home to hundreds of millions of people with restricted access to healthcare. More importantly, the findings will be used to develop and deploy bespoke, spatially-explicit, electronic decision-support tools incorporating point-of-care tests for the management of febrile illnesses. The impact of these and other interventions on improving outcomes for patients with febrile illness will be evaluated in follow-on projects using pragmatic cluster-randomised trials across the SEACTN villages and health facilities."

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Researchers

Adrianus (Arjen) Dondorp (EPMC Awardee)Arjun Chandna (EPMC Awardee)Elizabeth Ashley (EPMC Awardee)Elizabeth Batty (EPMC Awardee)Francois Nosten (EPMC Awardee)Frank Smithuis (EPMC Awardee)Mayfong Mayxay (EPMC Awardee)Nicholas Day (EPMC Awardee)Nicholas White (EPMC Awardee)Paul Newton (EPMC Awardee)Richard Maude (EPMC Awardee)Tom Peto (EPMC Awardee)Yoel Lubell (EPMC Awardee)

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Original classification

Innovations Priority Project

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