See the published version of this preprint at Malaria Journal.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
Research
Ronald Kiguba
Makerere University College of Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2636-4115
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objectives:To describe the patterns of malaria diagnosis and antimalarial use: monotherapy, missed Day 1 dosing and risk-factors.
Methods: Prospective cohort of consented adult inpatients on the medical and gynaecological wards of Uganda’s 1790-bed Mulago National Referral Hospital.
Results: One in five (19%, 146/762; 95% confidence interval (CI): 16% to 22%) inpatients had an admitting or discharge malaria diagnosis or both. Microscopy was requested in 77% (108/141; 95% CI: 69% to 83%) of inpatients with an admitting malaria diagnosis; results were available for 46% (50/108; 95% CI: 37% to 56%), of whom 42% (21/50; 95% CI: 28% to 57%) were positive. Artesunate (AS) only (47%, 47/100; 95% CI: 37% to 57%) was the most frequently hospital-administered antimalarial followed by quinine (Q) only (23%, 95% CI: 15% to 32%). A quarter (25%, 25/100; 95% CI: 17% to 35%) of the inpatients missed their Day 1 dose of hospital-initiated antimalarials. Nearly half (47%, 95% CI: 34% to 61%) of 57 inpatients on AS and 18%(95% CI: 4% to 32%) of 28inpatients on Q missed at least one day of dosing in Days 1-3. Number of admitting diagnoses was a significant risk-factor for missed Day 1 dosing of hospital-initiated antimalarials (OR = 2.7, 95% CI: 1.53-4.54; P-value < 0.001).
Conclusions: Half the malaria microscopy results were not available; yet, the rate of testing was high. Improvement in laboratory services, procurement, prescription, dispensing and administration of antimalarials could curb missed treatment for confirmed malaria cases, monotherapy and delayed doses.
Keywords
Antimalarials, antimalarial use, delayed initiation of antimalarials, missed doses, malaria microscopy, malaria diagnosis, missed day 1 dosing, risk factors, monotherapy, incomplete dosing
This is a list of supplementary files associated with this preprint. Click to download.
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Malaria Journal.
Version (no preprint)
Posted 03 Mar, 2021
Editor assigned
On 03 Mar, 2021
Submission checks complete
On 03 Mar, 2021
Editor invited
On 03 Mar, 2021
This version was not preprinted
Version (no preprint)
Posted 27 Feb, 2021
Editorial decision: Minor Revision
On 27 Feb, 2021
Editor assigned
On 21 Feb, 2021
Submission checks complete
On 21 Feb, 2021
Editor invited
On 21 Feb, 2021
This version was not preprinted
No community comments so far
Editorial decision: Minor Revision
On 23 Jan, 2021
Editor assigned
On 10 Dec, 2020
Submission checks complete
On 10 Dec, 2020
Editor invited
On 10 Dec, 2020
Version 1
Posted 27 May, 2020
No comments provided
Editorial decision: Major Revision
On 09 Nov, 2020
Reviewer #2 agreed
On 29 Sep, 2020
Review #1 received
Received 12 Jun, 2020
Reviewer #1 agreed
On 24 May, 2020
Reviewers invited
Invitations sent on 23 May, 2020
Editor assigned
On 21 May, 2020
Submission checks complete
On 20 May, 2020
Editor invited
On 20 May, 2020
First submitted
On 14 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
Learn more about our company.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at Malaria Journal.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Ronald Kiguba
Makerere University College of Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2636-4115
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Malaria Journal.
Version (no preprint)
Posted 03 Mar, 2021
Editor assigned
On 03 Mar, 2021
Submission checks complete
On 03 Mar, 2021
Editor invited
On 03 Mar, 2021
This version was not preprinted
Version (no preprint)
Posted 27 Feb, 2021
Editorial decision: Minor Revision
On 27 Feb, 2021
Editor assigned
On 21 Feb, 2021
Submission checks complete
On 21 Feb, 2021
Editor invited
On 21 Feb, 2021
This version was not preprinted
No community comments so far
Editorial decision: Minor Revision
On 23 Jan, 2021
Editor assigned
On 10 Dec, 2020
Submission checks complete
On 10 Dec, 2020
Editor invited
On 10 Dec, 2020
Version 1
Posted 27 May, 2020
No comments provided
Editorial decision: Major Revision
On 09 Nov, 2020
Reviewer #2 agreed
On 29 Sep, 2020
Review #1 received
Received 12 Jun, 2020
Reviewer #1 agreed
On 24 May, 2020
Reviewers invited
Invitations sent on 23 May, 2020
Editor assigned
On 21 May, 2020
Submission checks complete
On 20 May, 2020
Editor invited
On 20 May, 2020
First submitted
On 14 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Malaria Journal.
Objectives:To describe the patterns of malaria diagnosis and antimalarial use: monotherapy, missed Day 1 dosing and risk-factors.
Methods: Prospective cohort of consented adult inpatients on the medical and gynaecological wards of Uganda’s 1790-bed Mulago National Referral Hospital.
Results: One in five (19%, 146/762; 95% confidence interval (CI): 16% to 22%) inpatients had an admitting or discharge malaria diagnosis or both. Microscopy was requested in 77% (108/141; 95% CI: 69% to 83%) of inpatients with an admitting malaria diagnosis; results were available for 46% (50/108; 95% CI: 37% to 56%), of whom 42% (21/50; 95% CI: 28% to 57%) were positive. Artesunate (AS) only (47%, 47/100; 95% CI: 37% to 57%) was the most frequently hospital-administered antimalarial followed by quinine (Q) only (23%, 95% CI: 15% to 32%). A quarter (25%, 25/100; 95% CI: 17% to 35%) of the inpatients missed their Day 1 dose of hospital-initiated antimalarials. Nearly half (47%, 95% CI: 34% to 61%) of 57 inpatients on AS and 18%(95% CI: 4% to 32%) of 28inpatients on Q missed at least one day of dosing in Days 1-3. Number of admitting diagnoses was a significant risk-factor for missed Day 1 dosing of hospital-initiated antimalarials (OR = 2.7, 95% CI: 1.53-4.54; P-value < 0.001).
Conclusions: Half the malaria microscopy results were not available; yet, the rate of testing was high. Improvement in laboratory services, procurement, prescription, dispensing and administration of antimalarials could curb missed treatment for confirmed malaria cases, monotherapy and delayed doses.
This is a list of supplementary files associated with this preprint. Click to download.
Loading...