Skip to main content

Table 4 Association of endemicity and age with non-prescription of ACT among mRDT-positive patients

From: Patients with positive malaria tests not given artemisinin-based combination therapies: a research synthesis describing under-prescription of antimalarial medicines in Africa

Project site

mRDT positivity

Age (years)

Number (%) of mRDT-positive patients not prescribed ACT by proxy endemicity setting*

Unadjusted

Adjusted†

OR

95% CI‡

p value‡

OR

95% CI‡

p value‡

(i) Effect of endemicity setting on ACT non-prescription in baseline age group (< 5 years)

 Nige1

High

< 5

95/399 (23.8)

1.00

Ref.

0.004

1.00

Ref.

0.077

Mod–high

62/134 (46.3)

2.76

1.39, 5.45

1.98

0.93, 4.22

 Tanz1

Mod–high

< 5

47/173 (27.2)

1.00

Ref.

0.026

1.00

Ref.

0.027

Low

41/64 (64.1)

4.78

1.21, 18.93

4.80

1.19, 19.34

 Tanz2

Mod–low

< 5

770/4102 (18.8)

1.00

Ref.

0.001

1.00

Ref.

< 0.001

Low

177/294 (60.2)

6.55

2.88, 14.85

6.22

2.70, 14.35

 Uga2§

Mod–high

< 1

46/3364 (1.4)

1.00

Ref.

< 0.001

1.00

Ref.

< 0.001

Low

11/35 (31.4)

33.1

11.88, 92.00

32.49

11.36, 92.92

(ii) Effect of age on ACT non-prescription in differing areas of endemicity

 Nige1

High

< 5

10/26 (38.5)

1.00

Ref.

0.052

1.00

Ref.

0.051

≥ 5

85/373 (22.8)

0.47

0.22, 1.01

0.47

0.22, 1.00

Mod–high‖

< 5

6/16 (37.5)

–

–

–

–

–

–

≥ 5

56/118 (47.5)

 Tanz1

Mod–high

< 5

34/110 (30.9)

1.00

Ref.

0.226

1.00

Ref.

0.221

≥ 5

13/63 (20.6)

0.58

0.24, 1.40

0.58

0.24, 1.39

Low

< 5

30/43 (69.8)

1.00

Ref.

0.132

1.00

Ref.

0.124

≥ 5

11/21 (52.4)

0.48

0.18, 1.25

0.47

0.18, 1.23

 Tanz2

Mod–high

< 5

212/1429 (14.8)

1.00

Ref.

< 0.001

1.00

Ref.

< 0.001

≥ 5

558/2673 (20.9)

1.51

1.23, 1.86

1.51

1.23, 1.86

Low

< 5

35/51 (68.6)

1.00

Ref.

0.117

1.00

Ref.

0.109

≥ 5

142/243 (58.4)

0.64

0.37, 1.12

0.67

0.43, 1.09

 Uga2§

Mod–high

< 1

10/238 (4.2)

1.00

Ref.

0.012

1.00

Ref.

0.013

≥ 1

36/3104 (1.2)

0.27

0.10, 0.75

0.27

0.09, 0.75

Low‖

< 1

1/4 (25.0)

–

–

–

–

–

–

≥ 1

10/31 (32.3)

  1. *n is number of patients per study site not prescribed ACT among all mRDT-positive patients with complete data for age, gender, endemicity setting, sector, and intervention arm. Total number of mRDT-positive patients not prescribed ACT: N = 7291/104,454
  2. †All adjusted models included age and gender as a priori variables and where sufficient data available (≥ 10 outcomes per cell), plus all other variables found significant by univariate analyses (p < 0.05). Statistical models for each site vary in composition due to differences in study designs. Final regression models for each site include the following variables: Nige1—gender, age, sector, and endemicity; Tanz1—gender, age, and endemicity setting; Tanz2—gender, age, and endemicity setting; Uga2—gender, age, and endemicity setting; Nige1 (high)—gender and age; Tanz1 (mod–high)—gender and age; Tanz1 (low)—gender and age; Tanz2 (mod–high)—gender and age; Tanz2 (low)—gender, age, and intervention arm; and Uga2 (mod–high)—gender and age. Nige1 (mod–high) and Uga2 (low) had insufficient outcomes in binary age categories to undergo analysis
  3. ‡Confidence intervals and p value calculated using Wald’s test
  4. §Uga2 age categories </≥ 1 due to primary study limited to patients aged under 6 years
  5. ‖Analysis not undertaken due to insufficient number of outcomes
Back to article page

BMC Medicine

ISSN: 1741-7015

Contact us