Evidence mapPaperPMID 41825916Full record

Trial reportBMJ global health2026

Effect of a digital training package on clinical outcomes in Malawi's index case testing programme: a cluster randomised controlled trial.

Nora Rosenberg, Katie Mollan, Jiayu Wang, Tapiwa Tembo, Mike Chitani, Elizabeth Wetzel, Sarah E Rutstein, Victor Mwapasa, Duncan Phiri, Angella Mkandawire and 4 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05343390 (Enhancing HIV-assisted Contact Tracing in Malawi Through Blended Learning), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05343390 nacompletednot on this map

Enhancing HIV-assisted Contact Tracing in Malawi Through Blended Learning: an Implementation Science Study

TypeinterventionalSponsorUniversity of North Carolina, Chapel HillRan2021 to 2023Enrolled841ConditionsHuman Immunodeficiency VirusArmsEnhanced implementation package, Standard implementation package
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Nora RosenbergGillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Katie MollanCenter for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Jiayu WangGillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA mjw0@unc.edu.ORCID http://orcid.org/0000-0003-0021-4298
Tapiwa TemboBaylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.ORCID http://orcid.org/0000-0002-5649-0817
Mike ChitaniBaylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.
Elizabeth WetzelBaylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.
Sarah E RutsteinSchool of Medicine, University of North Carolina at, Chapel Hill, North Carolina, USA.ORCID http://orcid.org/0000-0002-1571-6576
Victor MwapasaSchool of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Duncan PhiriBaylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.
Angella MkandawireBaylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.
Vivian GoGillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Maria KimBaylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.
Saeed AhmedBaylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.
Katherine R SimonBaylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTraining health workers is a common implementation strategy to expand evidence-based interventions. Digital training is a promising way of reaching more health workers, minimising clinical interruptions and lowering costs, but clinical outcomes are rarely evaluated in low-income settings. Clinical outcomes were evaluated in Malawi's HIV index case testing programme through the Package of Resources for Assisted Contact Tracing: Implementation, Costs, and Effectiveness study.

methodsAn unblinded cluster randomised controlled trial was conducted in 33 health facilities in two Malawian districts (2022-2023). Facilities were stratified by district and size and randomly assigned 2:1 to receive standard training or standard training plus a digital-based package. The package included asynchronous role-modelling, small-group practice, one-on-one feedback and tablet-guided quality improvement. Participants were lay health workers involved in index case testing. Index clients were people diagnosed with HIV. Contact clients were their partners, children and household members. Five coprimary outcomes, abstracted from programme registers over 1 year, were assessed at the cluster level: index client participation, contacts elicited, contacts tested, new HIV diagnoses and self-test kit provision. Impacts were estimated using negative binomial mixed-effects models (α=0.05).

resultsClusters were randomly assigned to enhanced (n=11) or standard (n=22) arms and analysed in four 3-month increments (calendar-quarters) over a 1-year period. In each calendar quarter, clusters had a median of 281 potential index clients (IQR 220-427). Significant effects were observed for three primary outcomes: contact client elicitation (RR=1.37, 95% CI 1.10 to 1.71, p=0.006), contact client testing (RR=1.45, CI 1.10 to 1.92, p=0.01) and self-test kit provision (RR=2.29, 95% CI 1.19 to 4.40, p=0.01). Positive, but non-significant effects were observed for index client participation (RR=1.22, CI 0.93 to 1.60, p=0.1) and new HIV diagnoses (RR: 1.28, CI 0.94 to 1.76, p=0.1). No study-related adverse events occurred.

conclusionsEnhanced digital training positively impacted meaningful clinical outcomes and could be replicated for expansion to other evidence-based interventions. TRIAL REGISTRATION NUMBER: NCT05343390.

Indexed as

Contact TracingHIV InfectionsAdultCluster AnalysisFemaleHumansMalawiMaleAfricaCluster randomized trialGlobal HealthHIVTelemedicine

Identifiers

PMID41825916
PMCPMC12993308

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.