Rigor Reviewed

Rigor-Reviewed Manuscript

Permethrin-Treated Baby Wraps for the Prevention of Malaria.

Name: Adcurare Rigor Record — Permethrin-Treated Baby Wraps for the Prevention of Malaria.
Item: Permethrin-Treated Baby Wraps for the Prevention of Malaria.
Rating: 96
Author: Adcurare

Boyce RM, Shook-Sa BE, Ndizeye R, Baguma E, Giandomenico D, Cassidy CA, Eshun S, Siedner MJ, Staedke SG, Ntaro M, Juliano JJ, Reyes R, Mulogo EM

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Adcurare Rigor Review — 4.75★ (Strong), 0 critical, 3 high issues for “Permethrin-Treated Baby Wraps for the Prevention of Malaria.”

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Adcurare Editorial

This rigor review was examined and confirmed by Adcurare Editorial · July 7, 2026

Adcurare Rigor Review

Rigor Reviewed

4.75 / 5

Strong — minor issues to address

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

ReportingData & code availability partially met−0.25★

Model-reported confidence: highReviewer agreement: highEngine: 7.6.0Source: full text

Problems surfaced1 type

Data/code availability incomplete

This Adcurare Rigor Review uses AI Rigor Reviewers trained on a curated corpus of high-fidelity and retracted papers, with expert supervision and curation. It can still make mistakes; verify each finding against the source before relying on it.

This is a well-conducted and well-reported double-blind, randomized, placebo-controlled trial of permethrin-treated baby wraps for malaria prevention. The manuscript is methodologically rigorous, with clear randomization, blinding, a pre-specified power analysis, and comprehensive reporting of outcomes and limitations. The main weakness is the data and code availability statement, which lacks a named repository and does not mention code sharing.

All three independent reviewers (all AI) agreed on all dimension statuses, with only minor differences in checklist sub-ratings. The statistics verification component checked 1 test and found it consistent. The citation check found no retracted or missing references. The copyedit pass flagged 6 minor issues. The study is a human RCT, so several checklist items (e.g., species/strain, housing, IACUC) are not applicable.

9 major claims checked against the paper's own evidence: all adequately supported.

Recomputed 1 test: 1 consistent, 0 inconsistent, 1 via agent-written checks.

Reporting

Eight Dimensions7 pass · 1 warn

The introduction cites the high mortality from malaria in African children, the stagnation in progress, and the limitations of current interventions such as insecticide resistance, outdoor biting, and reduced vaccine efficacy in infants. It then posits that treating wraps used for carrying children could provide complementary protection. The rationale is logical and directly motivates the trial. Limitations of prior work (e.g., chemo-prevention feasibility, vaccine waning) are acknowledged, and the study is designed to address a gap in outdoor/daytime biting protection.

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

The paper clearly establishes the scientific premise, citing prior work on insecticide-treated clothing and the need for complementary malaria prevention tools.

Evidence

direct quote[Introduction, paragraph 3]

“Similar approaches have been employed for military uniforms, as well as clothing and blankets for refugees.”

direct quote[Introduction, paragraph 3]

“We hypothesized that treating wraps with repellent might provide an additional layer of protection against malaria.”

paraphrase[Introduction, paragraph 2-3]

“The introduction notes that existing vaccines have waning protection and are less effective in infants, and that outdoor biting during dawn/dusk hours is a gap in LLIN-focused strategies.”

PASSReviewer 2· 95% conf

The scientific premise is well-established with cited prior work, a clear rationale, and limitations of prior research acknowledged.

Evidence

paraphrase[Introduction, paragraphs 2-3]

“The paper states: 'Similar approaches have been employed for military uniforms, as well as clothing and blankets for refugees.'”

direct quote[Introduction, paragraph 3]

“Treatment of wraps has potential advantages including: (i) targeting young children who are most vulnerable to malaria, (ii) integration with existing cultural norms, (iii) offering protection against outdoor and daytime biting mosquitoes, and (iv) minimizing direct contact with permethrin because the wrap is worn over clothing.”

paraphrase[Introduction, paragraphs 1-2]

“The paper states that progress against malaria has stalled, citing insecticide resistance, outdoor biting, and reduced vaccine efficacy in infants as gaps that complementary innovations need to address.”

PASSReviewer 3· 97% conf

The paper establishes a clear rationale based on the high malaria burden in children, limitations of existing tools (nets, vaccines, chemoprevention), and the cultural practice of carrying children in wraps.

Evidence

direct quote[Introduction, paragraph 1]

“In 2023 there were nearly 600,000 deaths from malaria. Approximately 95% of these deaths occurred in the African region with most occurring among children under five years of age.”

direct quote[Introduction, paragraph 2]

“We hypothesized that treating wraps with repellent might provide an additional layer of protection against malaria.”

direct quote[Introduction, paragraph 3]

The paper explicitly states a double-blind, randomized, placebo-controlled design (Methods, paragraph 1). Randomization was 1:1, stratified by child's age group and site, using a permuted block design, performed on-site via REDCap (Methods, paragraph 'Recruitment, randomization and masking'). Participants and clinicians were blinded; a sham treatment (water soak) was used, though permethrin's odor could not be blinded. The sample size calculation is provided (n=400 to detect a 30% reduction with 80% power, two-sided α=0.05, assuming 3.0/100 person-weeks in control). Inclusion/exclusion criteria are clearly listed (adult women, child 6-18 months; exclusions: HIV, SCD, pyrethroid allergy, other malaria studies, twins). An intention-to-treat approach and the primary outcome definition are pre-specified. Outlier handling is not separately discussed but is implicit in the pre-specified statistical analysis plan. Independent replication is not reported (a single trial); this is n/a for a pivotal trial by our rules. The controls (sham-treated wraps) and the provision of a new LLIN to all participants are described.

Sub-criteria

controlsADEQUATE

power analysisADEQUATE

blinding levelsADEQUATE

outlier handlingINADEQUATE

randomization unitADEQUATE

inclusion exclusionADEQUATE

randomization methodADEQUATE

replicate distinctionN/A

independent replicationN/A

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

The study design is rigorous, with clear randomization, blinding, a pre-specified power analysis, and well-defined inclusion/exclusion criteria.

Evidence

direct quote[Methods, Recruitment, randomization and masking]

“Randomization was stratified by age of the child (age 6–11 months and 12–18 months) and clinical site, using a permuted block design. Randomization was performed on-site by a research assistant using REDCap.”

direct quote[Methods, Recruitment, randomization and masking]

“Study participants and clinicians remained blinded to the study allocation.”

direct quote[Methods, Statistical analysis]

“A total of 400 mother-infant pairs (200 per arm) were required to detect a 30% reduction in the incidence of clinical malaria (i.e., incidence rate ratio [IRR]=0.70) in the permethrin-treated arm relative to the sham-treated arm over the 24-week study period with a two-sided test, power of 0.80, and type I error 0.05.”

PASSReviewer 2· 98% conf

The randomized, double-blind, placebo-controlled trial design is rigorous; randomization, stratification, blinding, sample size justification, and inclusion/exclusion criteria are all adequately described.

Evidence

direct quote[Methods, paragraph 1 and 'Recruitment, randomization and masking']

“Randomization was stratified by age of the child (age 6–11 months and 12–18 months) and clinical site, using a permuted block design.”

direct quote[Methods, 'Statistical analysis']

“A total of 400 mother-infant pairs (200 per arm) were required to detect a 30% reduction in the incidence of clinical malaria... with a two-sided test, power of 0.80, and type I error 0.05.”

direct quote[Methods, 'Recruitment, randomization and masking']

“However, permethrin does have a distinct odor which could not be blinded.”

PASSReviewer 3· 98% conf

The trial is a well-designed double-blind, randomized, placebo-controlled trial with high adherence, a pre-specified analysis plan, and adequate handling of the per-protocol elements for a human RCT.

Evidence

direct quote[Methods, Recruitment, randomization and masking]

“Study participants and clinicians remained blinded to the study allocation. However, permethrin does have a distinct odor which could not be blinded”

direct quote[Methods, Statistical analysis]

The paper reports the sex of children (47% female in sham, 49% in permethrin arm), age in months (median 11-12 months), and maternal age. Health status is captured through baseline malaria testing, hemoglobin levels, and MUAC measurements. Demographics such as maternal education, household characteristics, and care-seeking behavior are also reported. Since both sexes are enrolled, a justification for single-sex is not applicable.

Sub-criteria

demographicsADEQUATE

sex reportedADEQUATE

sex justifiedN/A

age weight healthADEQUATE

housing conditionsN/A

species strain sourceN/A

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

Key biological variables for human subjects, including age, sex, and health status, are well-reported in the baseline table.

Evidence

direct quote[Table 1]

“Female | 94 (47.0) | 98 (49.0)”

direct quote[Table 1]

“Age in months (Median (Q1, Q3)) | 11.0 (8.0, 14.0) | 12.0 (8.0, 15.0)”

direct quote[Table 1]

“Maternal education (highest level) | Primary | 122 (61.0) | 117 (58.5)”

PASSReviewer 2· 95% conf

Key biological variables for human subjects (age, sex, demographics) are reported; species/strain/housing criteria are n/a for this human study.

Evidence

direct quote[Table 1]

“Female | 94 (47.0) | 98 (49.0) |”

direct quote[Table 1]

“Maternal age in years (Median (Q1, Q3)) | 25.0 (21.0, 30.2) | 26.5 (22.0, 32.0) |”

paraphrase[Table 1]

“MUAC median 14.3 cm in both arms; hemoglobin median ~12 g/dL; RDT positivity at home visit ~10% per arm.”

PASSReviewer 3· 95% conf

Key biological variables for the human participants (age, sex) and the vector population are adequately reported, while variables not applicable to a human trial (e.g., animal housing) are correctly omitted.

Evidence

direct quote[Table 1]

“Female | 94 (47.0) | 98 (49.0)”

direct quote[Table 1]

“Maternal education (highest level) | Primary | 122 (61.0) | 117 (58.5)”

The paper explicitly names three ethical bodies that approved the trial: the WCG Institutional Review Board, the Mbarara University of Science and Technology Research Ethics Committee, and the Uganda National Council of Science and Technology. It states that written informed consent was obtained from the mothers. Regulatory compliance is implied by adherence to the CONSORT guidelines and the approval by national and international bodies. The trial is also registered on ClinicalTrials.gov.

Sub-criteria

iacuc statementN/A

informed consentADEQUATE

irb ethics statementADEQUATE

regulatory complianceADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

Ethical approvals from named committees and informed consent are clearly reported.

Evidence

direct quote[Methods, Study Design]

“The trial was approved by the WCG Institutional Review Board, the Mbarara University of Science and Technology Research Ethics Committee, and the Uganda National Council of Science and Technology.”

direct quote[Methods, Study Design]

“Written informed consent was obtained from the mother.”

direct quote[Abstract]

“ClinicalTrials.gov (http://ClinicalTrials.gov) NCT05391230”

PASSReviewer 2· 95% conf

Ethics approval with named bodies and informed consent are clearly reported; regulatory compliance (CONSORT, Declaration of Helsinki implicitly via IRB) is stated.

Evidence

direct quote[Methods, paragraph 1]

“Written informed consent was obtained from the mother.”

direct quote[Methods, paragraph 1]

“This report adheres to the guidelines for Consolidated Standards of Reporting Trials.”

PASSReviewer 3· 99% conf

Ethical approvals from recognized institutional review boards, informed consent, and regulatory compliance are all properly documented.

Evidence

direct quote[Methods, Study Design]

“Written informed consent was obtained from the mother.”

For a human trial of a drug/device, the key resources are the investigational product and its comparator. The permethrin (manufacturer: Sawyer Products, concentration: 0.5%), the wraps (local cloth, described), and the bednets (PermaNet 2.0, Vestergaard) are identified. The statistical software (REDCap for randomization) and analysis approach (pre-specified plan) are mentioned, though a specific software for final analysis is not named. Antibodies, cell lines, and mycoplasma testing are not applicable.

Sub-criteria

mycoplasma testingN/A

reagents identifiedADEQUATE

organisms identifiedN/A

antibodies identifiedN/A

cell line authenticationN/A

software tools identifiedADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 90% conf

The investigational product (permethrin) and key materials are adequately identified, though some details are missing.

Evidence

direct quote[Methods, Interventions]

“Wraps were soaked in permethrin diluted to 0.5% in accordance with the manufacturer’s instructions (Sawyer Products, Safety Harbor, FL)”

direct quote[Methods, Interventions]

“All participants received a new, pyrethroid-only LLIN (PermaNet 2.0, Vestergaard).”

direct quote[Methods, Recruitment, randomization and masking]

“Randomization was performed on-site by a research assistant using REDCap.”

PASSReviewer 2· 93% conf

The investigational product (permethrin) and sham treatment are adequately identified; software tools (REDCap) named; wet-lab resources (antibodies, cell lines) are n/a.

Evidence

direct quote[Methods, 'Interventions']

“Wraps were soaked in permethrin diluted to 0.5% in accordance with the manufacturer’s instructions (Sawyer Products, Safety Harbor, FL).”

direct quote[Methods, 'Recruitment, randomization and masking']

“Randomization was performed on-site by a research assistant using REDCap.”

direct quote[Methods, 'Interventions']

“Participants randomized to the control arm received wraps that underwent a sham treatment by soaking in water.”

PASSReviewer 3· 96% conf

The investigational product (permethrin, wraps, bednets) is adequately identified, and software tools are named. Bench-level reagents are not applicable for this human clinical trial.

Evidence

direct quote[Methods, Interventions]

“Wraps were soaked in permethrin diluted to 0.5% in accordance with the manufacturer’s instructions (Sawyer Products, Safety Harbor, FL)”

direct quote[Methods, Interventions]

“All participants received a new, pyrethroid-only LLIN (PermaNet 2.0, Vestergaard).”

The primary analysis (IRR estimation) is described, with the test comparison (IRR, IRD, 95% CIs, p-value). Exact p-value is reported as p<0.001. The statistical software is not explicitly named in the main text, but the protocol and analysis plan are referenced (supplement). It is reasonable to infer standard software was used, but not explicitly stated. Assumptions_verified: For a large-sample rate comparison using Poisson-based methods, the design handles this; no explicit normality test is given. Effect sizes (IRR=0.34, IRD=-1.41) with CIs are reported. Data presentation: incidence rates, cumulative incidence curves (Figure 3), and baseline tables are provided. Per-group N is stated. Mathematical plausibility: The reported incidence rates (2.14 and 0.73 per 100 person-weeks) with person-time (4395 and 4641) yield 94.0 and 33.9 events, consistent with the 94 and 34 reported episodes. This is plausible. No demonstrable arithmetic errors detected. Sub-group Ns (age 6-11 and 12-18) are reported and sum correctly. Secondary outcomes are reported with CIs. Overall, ≥60% of applicable criteria are adequate.

Sub-criteria

tests namedADEQUATE

exact p valuesADEQUATE

effect sizes ciADEQUATE

data presentationADEQUATE

software identifiedINADEQUATE

assumptions verifiedINADEQUATE

mathematical plausibilityPASS

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 90% conf

Statistical methods are well-described, with named tests, exact p-values, and effect sizes with confidence intervals. Assumptions are not explicitly verified, but this is acceptable for a large trial using standard methods.

Evidence

direct quote[Methods, Statistical analysis]

“Incidence rates of clinical P. falciparum malaria in children over the 24-week follow-up period were calculated by arm and compared by estimating the IRR and incidence rate difference (IRD) with adjustments for stratification variables.”

direct quote[Abstract]

“p<0.001”

direct quote[Abstract]

“incidence rate ratio 0.34, 95% CI 0.23–0.51”

PASSReviewer 2· 93% conf

Statistical tests are named, exact p-values are reported (p<0.001 for primary), software is identified, and data presentation (incidence rate, CIs, cumulative incidence) is appropriate for a clinical trial.

Evidence

direct quote[Results, 'Primary Outcome' and Table 2]

“Clinical malaria incidence was 2.14 (95% CI 1.73–2.62) and 0.73 (95% CI 0.51–1.02) per 100 person weeks... incidence rate ratio 0.34, 95% CI 0.23–0.51, p<0.001.”

direct quote[Table 2]

“Clinical malaria episodes | 94 (73.4%) | 34 (26.6%) | Time at risk (person-weeks) | 4,395 | 4,641 |”

direct quote[Methods and Table 3]

“For secondary outcomes, 95% confidence intervals are presented. These intervals have not been adjusted for multiple comparisons and should not be interpreted as hypothesis tests.”

PASSReviewer 3· 92% conf

Statistical tests are named, exact p-values are reported, effect sizes with confidence intervals are provided, and data presentation is appropriate for a clinical trial.

Evidence

direct quote[Results, Primary Outcome]

“(incidence rate ratio 0.34, 95% CI 0.23–0.51, p<0.001)”

direct quote[Methods, Statistical analysis]

The data availability statement indicates that deidentified individual data will be shared from 9 to 36 months following publication, subject to IRB approval and a data use agreement. This is a concrete access route for patient-level data and is considered adequate. However, no mention is made of sharing the analysis code, which is a gap. The trial registration number is provided, which facilitates access to the protocol.

Sub-criteria

code sharingNOT REPORTED

accession numbersN/A

repository depositN/A

data availability statementADEQUATE

Per reviewer (3) — the votes behind the verdict

WARNReviewer 1· 90% conf

A data availability statement is present but describes managed access, which is appropriate for patient data. No code sharing is mentioned.

Evidence

direct quote[Availability of Data and Materials]

“Deidentified individual data that supports the results will be shared beginning 9 to 36 months following publication provided the investigator who proposes to use the data has approval from an Institutional Review Board (IRB), Independent Ethics Committee (IEC), or Research Ethics Board (REB), as applicable, and executes a data use/sharing agreement with UNC.”

absence[Availability of Data and Materials]

No code sharing is mentioned.

WARNReviewer 2· 90% conf

A data availability statement is present but is vague ('available from the corresponding author on reasonable request' with conditions that require IRB approval and a data use agreement); this is reported but inadequate per the tiered grading.

Evidence

direct quote[End of Discussion, 'Availability of Data and Materials']

“Deidentified individual data that supports the results will be shared beginning 9 to 36 months following publication provided the investigator who proposes to use the data has approval from an Institutional Review Board (IRB)... and executes a data use/sharing agreement with UNC.”

WARNReviewer 3· 90% conf

A data availability statement is present but is classified as inadequate because it only offers data 'on reasonable request' without a clear mechanism or platform, and no code is shared.

Evidence

direct quote[Discussion, Availability of Data and Materials]

The trial is registered at ClinicalTrials.gov (NCT05391230). The paper states adherence to the CONSORT guidelines. The primary outcome (clinical malaria) is clearly defined and reported. Null or negative secondary outcomes (e.g., change in hemoglobin, growth parameters) are reported transparently. Limitations are discussed thoroughly (generalizability, self-reported LLIN use, odor compromising blinding, lack of entomological endpoints). Conclusions are proportional, stating the wraps 'significantly reduced clinical malaria incidence' and calling for further research, without overclaiming. Funding sources are disclosed, and potential conflicts (e.g., Sawyer Products providing permethrin) are transparent.

Sub-criteria

funding coiADEQUATE

trial registrationADEQUATE

reporting guidelineADEQUATE

methods completenessADEQUATE

all outcomes reportedADEQUATE

limitations discussedADEQUATE

conclusions proportionalADEQUATE

Per reviewer (3) — the votes behind the verdict

PASSReviewer 1· 95% conf

The manuscript is well-structured, adheres to CONSORT guidelines, discusses limitations, and has proportional conclusions. Funding and conflicts are disclosed.

Evidence

direct quote[Methods, Study Design]

“This report adheres to the guidelines for Consolidated Standards of Reporting Trials.”

direct quote[Discussion]

“There are also important limitations. First, the study is most generalizable to contexts where baby wraps are used to carry young children.”

direct quote[Funding]

“Funding for the trial was provided by a Clinical Scientist Development Award to RMB from the Doris Duke Foundation (Award 24971).”

PASSReviewer 2· 95% conf

Methods are detailed enough for replication, trial is registered (NCT05391230), CONSORT guideline is followed, all prespecified outcomes (primary, secondary, safety) are reported, limitations are discussed, conclusions are proportional, and funding/COI is provided.

Evidence

direct quote[Abstract and end of Introduction]

“ClinicalTrials.gov (http://ClinicalTrials.gov) NCT05391230”

direct quote[Methods, paragraph 1]

“This report adheres to the guidelines for Consolidated Standards of Reporting Trials.”

direct quote[Discussion, paragraph 5]

“First, the study is most generalizable to contexts where baby wraps are used to carry young children. Second, our trial took place at one geographic location.”

PASSReviewer 3· 97% conf

The trial is registered, follows CONSORT guidelines, reports a pre-specified primary outcome, discusses limitations, and draws proportional conclusions.

Evidence

direct quote[Abstract]

“ClinicalTrials.gov NCT05391230”

direct quote[Methods, Study Design]

“This report adheres to the guidelines for Consolidated Standards of Reporting Trials.”

direct quote[Discussion, paragraph 5]

“First, the study is most generalizable to contexts where baby wraps are used to carry young children. Second, our trial took place at one geographic location.”

6 copyedit issues flagged: mostly other, consistency, clarity.

Checked 30 references: 22 verified — 8 not checked.

Reproducibility

3 data/code links checked; 2 live.

Registered (1 ID: ClinicalTrials.gov). Reporting guideline cited: CONSORT.

Adcurare Rigor Action ItemsFinal pass before journal submission

The manuscript is ready for submission after addressing the minor pre-submission action items listed below. The most important fixes are adding a named data repository or platform to the data availability statement, explicitly naming the statistical software and version, and adding an explicit conflicts-of-interest statement. The copyedit issues are minor and should be corrected for a clean submission.

1.
HIGHdata code
Add a named repository or managed-access platform (e.g., Vivli, YODA) to the data availability statement, and include a persistent identifier or contact mechanism.
The current statement is conditional and lacks a concrete access route, which may be considered inadequate by reviewers or journals.
2.
HIGHreporting
Add an explicit conflicts-of-interest statement (e.g., 'The authors declare no competing interests' or a detailed disclosure) to the end of the manuscript.
A missing COI statement is a reporting gap that journals require; even if none exist, it must be stated.
3.
HIGHstatistics
Name the specific statistical software package (e.g., SAS, R, Stata) and version used for all analyses in the Statistical Analysis section.
Software identification is a standard reproducibility requirement; its absence is a minor but fixable gap.
4.
MEDIUMstatistics
Add a brief statement in the Statistical Analysis section confirming that Poisson model assumptions (e.g., overdispersion) were assessed and handled (e.g., 'Overdispersion was assessed and not present, or a robust variance estimator was used').
Explicitly verifying assumptions strengthens the statistical reporting and preempts reviewer questions.
5.
MEDIUMdata code
If any custom analysis code was written for the primary or sensitivity analyses, deposit it in a public repository (e.g., GitHub, Zenodo) with a DOI and mention it in the data availability statement.
Code sharing enhances reproducibility; its absence is a gap noted by all reviewers.
6.
MEDIUMreporting
Provide the version number for REDCap in the randomization section.
Software version details improve reproducibility and are a standard expectation.
7.
MEDIUMreporting
In the Discussion, consider adding a sentence about the potential for unmeasured confounding or selection bias, even though randomization mitigates this.
Acknowledging residual confounding strengthens the limitations section and shows thoroughness.
8.
LOWcopyedit
In Methods, Interventions: add a comma after 'arms' for clarity: 'Retreatment occurred in both arms, every four weeks during study visits.'
Minor punctuation fix for readability.
9.
LOWcopyedit
In Methods, Statistical analysis: rephrase 'Time at risk accounted for censoring of the 28-day period following infection' to 'Time at risk accounted for censoring during the 28-day period following infection.'
Slight grammatical improvement for clarity.
10.
LOWcopyedit
In Abstract, Methods: change 'age 6 to 18 months' to 'aged 6 to 18 months' for consistency.
Minor phrasing inconsistency.
11.
LOWcopyedit
In Results, 'Primary Outcome': remove the stray 'and' before 'occurring': 'with 34 (26.6%) and 94 (73.4%) occurring in the permethrin- and sham-treated arms, respectively.'
Grammatical error: extra 'and'.
12.
LOWcopyedit
In Methods, Interventions: rephrase 'if the child was febrile during the visit or had a reported fever in the past 24 hours' to 'if the child was febrile at the visit or had a reported fever in the preceding 24 hours'.
Minor phrasing improvement for clarity.

Full text (36,378 chars)Analyzed: Jul 7, 2026

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