Quality of care for adult in-patients with malaria in a tertiary hospital in Uganda
Abstract Background Prompt detection and appropriate treatment of malaria prevents severe disease and death. The quality of care for adult malaria in-patients is not well documented in sub-Saharan Africa, particularly in Uganda. The study sought to describe the patterns of malaria diagnosis and trea...
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ftdoajarticles:oai:doaj.org/article:5a451bfe34aa44559c2574d31bb3d483 2023-05-15T15:17:38+02:00 Quality of care for adult in-patients with malaria in a tertiary hospital in Uganda Ronald Kiguba Charles Karamagi Sheila M. Bird 2021-04-01T00:00:00Z https://doi.org/10.1186/s12936-021-03712-3 https://doaj.org/article/5a451bfe34aa44559c2574d31bb3d483 EN eng BMC https://doi.org/10.1186/s12936-021-03712-3 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-03712-3 1475-2875 https://doaj.org/article/5a451bfe34aa44559c2574d31bb3d483 Malaria Journal, Vol 20, Iss 1, Pp 1-15 (2021) Antimalarial use Delayed initiation of antimalarials Malaria diagnosis Missed day 1 dosing Risk factors Incomplete dosing Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2021 ftdoajarticles https://doi.org/10.1186/s12936-021-03712-3 2022-12-31T15:18:54Z Abstract Background Prompt detection and appropriate treatment of malaria prevents severe disease and death. The quality of care for adult malaria in-patients is not well documented in sub-Saharan Africa, particularly in Uganda. The study sought to describe the patterns of malaria diagnosis and treatment among adult in-patients admitted to the medical and gynaecological wards of Uganda’s 1790-bed Mulago National Referral Hospital from December 2013 to April 2014. Methods A prospective cohort of 762 consented in-patients aged ≥ 18 years was assembled. Proportions of in-patients who received preadmission and in-hospital anti-malarials, missed Day 1 dosing of hospital-initiated anti-malarials and/or had malaria microscopy done were determined. Multivariable logistic regression was used to identify risk-factors for missed Day 1 dosing of anti-malarials. Results One in five (19%, 146/762) in-patients had an admission or discharge malaria diagnosis or both; with median age of 29 years (IQR, 22–42 years). Microscopy was requested in 77% (108/141) of in-patients with an admission malaria diagnosis; results were available for 46% (50/108), of whom 42% (21/50) tested positive for Plasmodium falciparum malaria parasitaemia. Only 13% (11/83) of in-patients who received in-hospital injectable artesunate (AS) or quinine (Q) received follow-up oral artemether-lumefantrine (AL); 2 of 18 severe malaria cases received follow-up oral AL. Injectable AS only (47%, 47/100) was the most frequent hospital-initiated anti-malarial treatment followed by injectable Q only (23%, 23/100) amongst in-patients who received in-hospital anti-malarials. A quarter (25%, 25/100; 95% CI: 17–35%) of in-patients missed Day 1 dosing of hospital-initiated anti-malarials. Each additional admission diagnosis was more than two-fold likely to increase the odds of missed Day 1 dosing of in-hospital anti-malarials (aOR = 2.6, 95% CI: 1.52–4.56; P-value = 0.001). Conclusions Half the malaria microscopy results were not available; yet, the rate of testing was ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 20 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Antimalarial use Delayed initiation of antimalarials Malaria diagnosis Missed day 1 dosing Risk factors Incomplete dosing Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Antimalarial use Delayed initiation of antimalarials Malaria diagnosis Missed day 1 dosing Risk factors Incomplete dosing Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Ronald Kiguba Charles Karamagi Sheila M. Bird Quality of care for adult in-patients with malaria in a tertiary hospital in Uganda |
topic_facet |
Antimalarial use Delayed initiation of antimalarials Malaria diagnosis Missed day 1 dosing Risk factors Incomplete dosing Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Prompt detection and appropriate treatment of malaria prevents severe disease and death. The quality of care for adult malaria in-patients is not well documented in sub-Saharan Africa, particularly in Uganda. The study sought to describe the patterns of malaria diagnosis and treatment among adult in-patients admitted to the medical and gynaecological wards of Uganda’s 1790-bed Mulago National Referral Hospital from December 2013 to April 2014. Methods A prospective cohort of 762 consented in-patients aged ≥ 18 years was assembled. Proportions of in-patients who received preadmission and in-hospital anti-malarials, missed Day 1 dosing of hospital-initiated anti-malarials and/or had malaria microscopy done were determined. Multivariable logistic regression was used to identify risk-factors for missed Day 1 dosing of anti-malarials. Results One in five (19%, 146/762) in-patients had an admission or discharge malaria diagnosis or both; with median age of 29 years (IQR, 22–42 years). Microscopy was requested in 77% (108/141) of in-patients with an admission malaria diagnosis; results were available for 46% (50/108), of whom 42% (21/50) tested positive for Plasmodium falciparum malaria parasitaemia. Only 13% (11/83) of in-patients who received in-hospital injectable artesunate (AS) or quinine (Q) received follow-up oral artemether-lumefantrine (AL); 2 of 18 severe malaria cases received follow-up oral AL. Injectable AS only (47%, 47/100) was the most frequent hospital-initiated anti-malarial treatment followed by injectable Q only (23%, 23/100) amongst in-patients who received in-hospital anti-malarials. A quarter (25%, 25/100; 95% CI: 17–35%) of in-patients missed Day 1 dosing of hospital-initiated anti-malarials. Each additional admission diagnosis was more than two-fold likely to increase the odds of missed Day 1 dosing of in-hospital anti-malarials (aOR = 2.6, 95% CI: 1.52–4.56; P-value = 0.001). Conclusions Half the malaria microscopy results were not available; yet, the rate of testing was ... |
format |
Article in Journal/Newspaper |
author |
Ronald Kiguba Charles Karamagi Sheila M. Bird |
author_facet |
Ronald Kiguba Charles Karamagi Sheila M. Bird |
author_sort |
Ronald Kiguba |
title |
Quality of care for adult in-patients with malaria in a tertiary hospital in Uganda |
title_short |
Quality of care for adult in-patients with malaria in a tertiary hospital in Uganda |
title_full |
Quality of care for adult in-patients with malaria in a tertiary hospital in Uganda |
title_fullStr |
Quality of care for adult in-patients with malaria in a tertiary hospital in Uganda |
title_full_unstemmed |
Quality of care for adult in-patients with malaria in a tertiary hospital in Uganda |
title_sort |
quality of care for adult in-patients with malaria in a tertiary hospital in uganda |
publisher |
BMC |
publishDate |
2021 |
url |
https://doi.org/10.1186/s12936-021-03712-3 https://doaj.org/article/5a451bfe34aa44559c2574d31bb3d483 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 20, Iss 1, Pp 1-15 (2021) |
op_relation |
https://doi.org/10.1186/s12936-021-03712-3 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-03712-3 1475-2875 https://doaj.org/article/5a451bfe34aa44559c2574d31bb3d483 |
op_doi |
https://doi.org/10.1186/s12936-021-03712-3 |
container_title |
Malaria Journal |
container_volume |
20 |
container_issue |
1 |
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1766347865430425600 |