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Table 4 Association of health outcome at day 28 follow-up and selected predictors, including pre-referral RAS treatment

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

 

Covariate

OR

(95% CI)

Covariate

OR

(95% CI)

Covariate

OR

(95% CI)

A) Dead at follow-up

DRC

Nigeria

Uganda

 Unadjusted

RAS use

1.25

(0.81–1.93)

RAS use

2.95

(1.78–4.90)

RAS use

0.70

(0.29–1.74)

 Adjusteda

RAS use

1.96

(0.88–4.35)

RAS use

2.57

(1.40–4.73)

n/ac

  

 Adjusted further for referral and post-referral treatment at RHFa

RAS use

3.06

(1.35–6.92)

RAS use

2.16

(1.11–4.21)

n/ac

  

Referral

  

Referral

     

Same or next day

Ref.

 

Same or next day

Ref.

    

Late

1.21

(0.71–2.07)

Late, not completed, unknown

1.58

(0.72–3.47)

   

Not completed

0.20

(0.10–0.39)

      

Unknown

0.82

(0.33–2.02)

      

Treatment

  

Treatment

     

Inj. AS/ART/QU only

Ref.

 

Inj. AS/ART/QU only

Ref.

    

ACT only

0.36

(0.07–1.70)

ACT only

n/a

    

Both

0.13

(0.07–0.24)

Both

n/a

    

None

1.14

(0.56–2.33)

None

5.85

(1.06–32.35)

   

Unknown

2.07

(1.10–3.90)

Unknown

7.65

(2.72–21.53)

   

B) Dead or sick at follow-up

DRC

Nigeria

Uganda

 Unadjusted

RAS use

0.84

(0.65–1.08)

RAS use

1.95

(1.27–3.01)

RAS use

0.40

(0.33–0.49)

 Adjustedb

RAS use

0.75

(0.51–1.13)

RAS use

1.62

(1.01–2.58)

RAS use

0.57

(0.43–0.76)

 Adjusted further for referral and post-referral treatment at RHFb

RAS use

0.88

(0.59–1.32)

RAS use

1.42

(0.85–2.36)

RAS use

0.60

(0.45–0.79)

Referral

  

Referral

  

Referral

  

Same or next day

Ref.

 

Same or next day

Ref.

 

Same or next day

Ref.

 

Late

0.93

(0.67–1.30)

Late

3.20

(1.21–8.42)

Late

0.85

(0.55–1.32)

Not completed

0.36

(0.22–0.60)

Not completed

2.39

(1.08–5.29)

Not completed

0.74

(0.60–0.91)

Unknown

0.82

(0.46–1.47)

Unknown

1.28

(0.55–2.97)

Unknown

0.93

(0.55–1.58)

Treatment

  

Treatment

  

Treatment

  

Inj. AS/ART/QU only

Ref.

 

Inj. AS/ART/QU only

Ref.

 

Inj. AS/ART/QU only

Ref.

 

ACT only

0.28

(0.10–0.75)

ACT only

n/a

 

ACT only

1.06

(0.68–1.64)

Both

0.40

(0.29–0.56)

Both

n/a

 

Both

0.52

(0.33–0.83)

None

0.89

(0.53–1.52)

None

4.58

(0.97–21.59)

None

1.34

(0.77–2.33)

Unknown

1.11

(0.68–1.80)

Unknown

3.26

(1.41–7.51)

Unknown

1.47

(0.96–2.26)

  1. ACT Artemisinin-based combination therapy, AS Artesunate, ART Artemether, n/a not applicable, QU Quinine, RAS Rectal artesunate
  2. aFixed effects, DRC: sex, age <1 year, beginning of RAS roll-out, convulsions, enrolment location (CHW vs. PHC), rainy season; Nigeria: convulsions, enrolment location (CHW vs. PHC); random effect: enrolling provider (all countries)
  3. bTreatment coded ‘unknown’ for patients who did not complete referral; fixed effects, DRC: sex, age <1 year, beginning of RAS roll-out, convulsions, enrolment location (CHW vs. PHC), rainy season, health zone, Nigeria: convulsions, enrolment location (CHW vs. PHC); Uganda: sex, age <1 year, beginning of RAS roll-out, convulsions, rainy season, district; random effect: enrolling provider (all countries)
  4. cNo adjusted models were calculated due to an insufficient number of events (death)