Skip to main content

Table 3 Sub-national differences in the effect of diagnostic testing on paediatric fever treatment in studied countries

From: Effect of diagnostic testing on medicines used by febrile children less than five years in 12 malaria-endemic African countries: a mixed-methods study

Country

Outcome

Strata

n febrile under fives taken to any care

% with outcome (95% CI)

% with a diagnostic test (95% CI)

AOR (95% CI)

p value

Malaria risk

       

Benin

Any anti-malarial use

High risk

403

50.8 (45.3-56.3)

20.0 (16.1-24.4)

2.30 (1.10-4.82)

0.028

  

Moderate risk

212

41.4 (32.9-50.5)

18.7 (11.9-28.1)

0.32 (0.08-1.29)

0.108

Burundi*

Any antibiotic use

Moderate risk

1,239

54.0 (49.8-58.2)

37.7 (33.8-41.6)

0.44 (0.32-0.60)

<0.001

  

Low risk

125

57.3 (42.7-71.8)

37.1 (27.2-47.0)

6.75 (1.30-35.00)

0.023

Malawi

Any anti-malarial use

High risk

1,870

56.9 (53.8-60.1)

19.5 (16.8-22.2)

1.63 (1.26-2.11)

<0.001

  

Moderate risk

2,361

53.2 (49.5-56.9)

22.8 (19.3-26.3)

1.12 (0.85-1.47)

0.410

Uganda

ACT use

High risk

1,730

46.1 (41.5-50.9)

26.9 (23.3-30.8)

0.95 (0.70-1.28)

0.736

  

Moderate risk

625

51.6 (46.2-57.1)

34.7 (28.9-41.1)

0.67 (0.46-0.98)

0.040

 

Any antibiotic use

High risk

1,730

36.6 (32.9-40.4)

26.9 (23.3-30.8)

1.24 (0.93-1.65)

0.146

  

Moderate risk

625

33.0 (28.3-38.1)

34.7 (28.9-41.1)

1.68 (1.12-2.52)

0.012

Source of care

       

Malawi

Any antibiotic use

Public

2,978

27.6 (25.2-30.0)

19.3 (17.2-21.4)

0.85 (0.67-1.09)

0.199

  

Private

1,358

34.0 (30.2-37.8)

26.0 (21.7-30.4)

1.36 (0.95-1.96)

0.097

Rwanda*

Any anti-malarial use

Public

522

24.4 (20.8-28.4)

40.3 (35.8-44.8)

0.59 (0.31-1.14)

0.119

  

Private

134

5.0 (2.3-10.8)

22.4 (15.6-31.1)

29.38 (2.25-383.63)

0.010

Symptoms

       

Benin*

Any anti-malarial use

Fever alone

380

46.6 (40.9-52.5)

15.5 (11.8-20.1)

0.94 (0.39-2.29)

0.893

  

Fever, cough, rapid breaths

239

50.5 (43.1-57.8)

27.2 (21.0-34.5)

5.48 (1.27-23.63)

0.022

Burkina Faso

Any anti-malarial use

Fever alone

1,253

48.5 (44.9-52.2)

6.9 (5.5-8.6)

2.03 (1.13-3.66)

0.018

  

Fever, cough, rapid breaths

570

46.7 (42.0-51.5)

9.5 (6.9-12.8)

0.69 (0.34-1.41)

0.304

Malawi

ACT use

Fever alone

1,980

51.7 (48.4-54.9)

21.9 (19.3-24.5)

0.87 (0.66-1.13)

0.298

  

Fever, cough, rapid breaths

2,355

42.2 (39.1-45.4)

21.0 (18.1-23.9)

1.40 (1.09-1.79)

0.008

 

Any antibiotic use

Fever alone

1,980

18.2 (16.0-20.4)

21.9 (19.3-24.5)

1.46 (1.07-1.99)

0.017

  

Fever, cough, rapid breaths

2,355

39.2 (36.2-42.2)

21.0 (18.1-23.9)

0.77 (0.60-1.00)

0.052

Senegal*

ACT use

Fever alone

527

5.6 (3.3-9.1)

15.1 (11.5-19.6)

75.42 (1.09-5212.78)

0.045

  

Fever, cough, rapid breaths

747

5.5 (3.2-9.3)

14.8 (11.1-19.4)

1.69 (0.50-5.73)

0.400

  1. If evidence of an interaction was found (0.05 level) between diagnostic testing and investigated variables (malaria risk, transmission season, age, symptoms, source of care) within a country, the final model was stratified accordingly and results presented above. CI = confidence interval; AOR = adjusted odds ratio. AORs are based on mixed-effects logistic regression models for specified strata in each country dataset adjusted for data clustering and confounding covariates (malaria endemicity; transmission season; public/private source; level of care; child’s age and sex; maternal age and education; residence; household wealth and size; health care access (money); health care access (distance); symptoms; health card).
  2. *Some results should be interpreted with caution due to few observations and few positive outcomes.
Back to article page

Malaria Journal

ISSN: 1475-2875

Contact us