Effectiveness of rectal artesunate as pre-referral treatment for severe malaria in children under 5 years of age: a multi-country observational study

Table 3 Health outcomes at day 28 follow-up by country, RAS implementation phase, and RAS use

	DRC			Nigeria			Uganda			Between-country p-value
	n/N	(%)	P-value*	n/N	(%)	P-value*	n/N	(%)	P-value*	Between-country p-value
Case fatality rate
Overall	135/2011	(6.7)		69/589	(11.7)		19/3686	(0.5)		<0.001
Implementation
Pre-RAS	20/304	(6.6)		9/217	(4.2)		4/1441	(0.3)
Post-RAS	115/1707	(6.7)	0.92	60/372	(16.1)	<0.001	15/2245	(0.7)	0.14
RAS use
No	27/475	(5.7)		30/391	(7.7)		12/2018	(0.6)
Yes	108/1536	(7.0)	0.34	39/198	(19.7)	<0.001	7/1668	(0.4)	0.45
Sick at day 28 follow-up
Overall	242/2011	(12.0)		34/589	(5.8)		589/3686	(16.0)		0.002
Implementation
Pre-RAS	40/304	(13.2)		20/217	(9.2)		299/1441	(20.8)
Post-RAS	202/1707	(11.8)	0.59	14/372	(3.8)	0.007	290/2245	(12.9)	0.003
RAS use
No	72/475	(15.2)		25/391	(6.4)		428/2018	(21.2)
Yes	170/1536	(11.1)	0.04	9/198	(4.6)	0.30	161/1668	(9.7)	<0.001
mRDT-positive at day 28 follow-up
Overall	811/1843	(44.0)		256/510	(50.2)		2547/3667	(69.5)		<0.001
Implementation
Pre-RAS	159/284	(56.0)		97/208	(46.6)		953/1437	(66.3)
Post-RAS	652/1559	(41.8)	<0.001	159/302	(52.7)	0.27	1594/2230	(71.5)	0.02
RAS use
No	235/444	(52.9)		168/357	(47.1)		1405/2006	(70.0)
Yes	576/1399	(41.2)	<0.001	88/153	(57.5)	0.03	1142/1661	(68.8)	0.44
Severe anaemia (Hb < 7 g/dL) at day 28 follow-up
Overall	65/1875	(3.5)		33/514	(6.4)		151/3379	(4.5)		0.054
Implementation
Pre-RAS	14/284	(4.9)		21/208	(10.1)		69/1256	(5.5)
Post-RAS	51/1591	(3.2)	0.09	12/306	(3.9)	0.02	82/2123	(3.9)	0.03
RAS use
No	23/447	(5.2)		24/359	(6.7)		105/1817	(5.8)
Yes	42/1428	(2.9)	0.03	9/155	(5.8)	0.75	46/1562	(2.9)	<0.001

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