Health worker adherence to malaria treatment guidelines at outpatient health facilities in southern Malawi following implementation of universal access to diagnostic testing

Table 7 Factors associated with appropriate treatment among presumed uncomplicated malaria patients^a (N = 178)

Factors	Number of patients	Number treated (weighted %)	Unadjusted OR (95% CI)	p value	Adjusted OR (95% CI)	p value
Patient spontaneously reported fever to the HW
Yes	126	79 (68.6)	3.5 (1.7–7.3)	0.001	5.7 (1.9–17.6)	0.002
No	52	19 (38.4)	Ref		Ref
Patient temperature (°C)—surveyor measured			1.3 (1.0–1.7)	0.032	1.5 (1.1–1.9)	0.005
HW age (years)			1.0 (1.0–1.1)	0.001	1.1 (1.0–1.1)	<0.0001
Number of supervision visits			1.1 (0.9–1.3)	0.135	1.2 (1.0–1.4)	0.029

Data from facilities unable to test patients at the time of the survey
^aOnly statistically significant factors with p < 0.05 in the multivariable analysis have odds ratio estimates shown in the table above. Other factors included in the logistic regression model were: patient age in years, patient spontaneous complaint of cough and headache (which was a confounder). Other factors with p value ≥0.1 in the univariate analysis that were not included in the multivariable model were: (1) Patient-level factors: patient spontaneous report of malaria, vomiting, chills, fatigue, joint pain, skin problem, weakness or cough to the HW; (2) HW-level factors: Number of patients seen by the HW, number of years of formal training received, number of years of clinical experience, latest training on malaria case management, and access to the latest malaria treatment guidelines; (3) HF-level factors: MoH vs CHAM operated HFs, availability of thermometers, number of patients at the HF and the number of HWs at the HF

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