Background:

On the African continent the majority of countries are developing countries. Given the more extreme limitations in health resources in these countries, there is a greater need for prioritization of healthcare expenditure. Consequently there is a greater need for the best available evidence on relevant interventions. The ATR is a database of controlled trials performed in Africa and has been compiled by the South African Cochrane Centre. Together with other relevant information, the ATR aims to contribute to evidence-based health care decision-making in Africa and to raise awareness of clinical effectiveness research conducted in Africa.

Objective:

To bring together all published and unpublished trials conducted in Africa into a central register.

Methods:

Journals published in Africa were hand searched back to 1948, or the first year of publication, to identify eligible studies for inclusion. Six of these journals are indexed on MEDLINE. Searching MEDLINE and EMBASE identified further journals for hand searching.
An appropriate search profile was compiled and is used to search The Cochrane Controlled Trials Register and the African Health Anthology (AHA) to identify trials for inclusion in the register. Update searches are performed on a quarterly basis. Other non-African-specific databases not currently being searched systematically for The Cochrane Controlled Trials Register are also being searched for reports of trials.

Results:

There are 2954 records in the register. Of these 1160 records were identified from journals published in African continent, with the remainder from journals published elsewhere. The register contains 1970 RCTs and 869 CCTs with the balance consisting of cohort and other non-randomised trials. Of the included trials 1468 are from journals indexed on MEDLINE and 184 from journals indexed on EMBASE. The remaining 1010 records were identified through hand searching.

Conclusions:

It is not always possible to use first world results in a third world setting. This database therefore provides essential information for decision makers in Africa. The database provides a unique opportunity to describe African trials, including 'lost science' not identifiable via large electronic databases. It also provides an opportunity to study patterns of research into healthcare interventions in Africa.