Table 5.
Prescribing That Should Have Resulted if the Diagnostic and Treatment Algorithm Were Strictly Followed, for Intervention-Arm Patients by Malaria Rapid Diagnostic Test Result, Among Patients Who Actually Received an Antibiotic Prescription and Those Who Did Not
| Prescribing Guidance if Algorithm Were Strictly Followed | All mRDTs | All Sites | Aduku (Kwania District) |
Nagongera (Tororo District) |
Kihihi (Kanungu District) |
|||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Neg | Pos | Neg | Pos | Neg | Pos | Neg | Pos | |||||||||||
| n | % | n | % | n | % | n | % | n | % | n | % | n | % | n | % | n | % | |
| Received antibiotic prescription | ||||||||||||||||||
| Don’t prescribe antibiotic | 235 | 35.6 | 47 | 13.5 | 188 | 60.1 | 2 | 1.8 | 61 | 44.2 | 9 | 8.8 | 64 | 88.9 | 36 | 26.5 | 63 | 61.2 |
| Prescribe antibiotic if clinically indicateda or if CRP and/or CBC elevated | 68 | 10.3 | 68 | 19.5 | 0 | 0.0 | 21 | 19.1 | 0 | 0.0 | 23 | 22.5 | 0 | 0.0 | 24 | 17.6 | 0 | 0.0 |
| Prescribe antibiotic | 358 | 54.2 | 233 | 67.0 | 125 | 39.9 | 87 | 79.1 | 77 | 55.8 | 70 | 68.6 | 8 | 11.1 | 76 | 55.9 | 40 | 38.8 |
| Total | 661 | 100 | 348 | 100 | 313 | 100 | 110 | 100 | 138 | 100 | 102 | 100 | 72 | 100 | 136 | 100 | 103 | 100 |
| Did not receive antibiotic prescription | ||||||||||||||||||
| Don’t prescribe antibiotic | 403 | 76.5 | 222 | 65.3 | 181 | 96.8 | 61 | 82.4 | 79 | 100 | 112 | 60.9 | 40 | 100 | 49 | 59.8 | 62 | 91.2 |
| Prescribe antibiotic if clinically indicateda or if CRP and/or CBC elevated | 107 | 20.3 | 107 | 31.5 | 0 | 0.0 | 13 | 17.6 | 0 | 0.0 | 71 | 38.6 | 0 | 0.0 | 23 | 28.0 | 0 | 0.0 |
| Prescribe antibiotic | 17 | 3.2 | 11 | 3.2 | 6 | 3.2 | 0 | 0.0 | 0 | 0.0 | 1 | 0.5 | 0 | 0.0 | 10 | 12.2 | 6 | 8.8 |
| Total | 527 | 100 | 340 | 100 | 187 | 100 | 74 | 100 | 79 | 100 | 184 | 100 | 40 | 100 | 82 | 100 | 68 | 100 |
Among those who actually received an antibiotic prescription, the top row (“Don’t prescribe antibiotic”; bold values), shows over-prescription (ie, patients for whom strict adherence to the algorithm would have resulted in no antibiotic, but who in fact were prescribed an antibiotic). Among those who did not receive an antibiotic prescription, the third row (“Prescribe antibiotic”, bold values) shows under-prescription (ie, patients for whom strict adherence to the algorithm would have resulted in an antibiotic, but who in fact were not prescribed one).
Abbreviations: CBC, complete blood count; CRP, C-reactive protein; mRDT, malaria rapid diagnostic test; Neg, negative; Pos, positive.
If clinically indicated in the clinician's judgment and/or if the patient was aged <5 years and met World Health Organization (WHO) pneumonia criteria.