Table 3.
Estimated associations between selected factors and referral completion in DRC and Uganda
| DRC | Uganda | |||||||||
| N§ | Referral completion (%) | Adjusted OR* | 95% CI | P value | N§ | Referral completion (%) | Adjusted OR* | 95% CI | P value | |
| All | 2104 | 66.9 | 3745 | 57.9 | ||||||
| Study group | ||||||||||
| Pre-RAS | 368 | 71.2 | Ref. | 1479 | 62.9 | Ref. | ||||
| Post-RAS | ||||||||||
| No RAS use | 188 | 75.5 | 0.34 | 0.18 to 0.66 | 0.001 | 635 | 57.5 | 0.80 | 0.63 to 1.01 | 0.06 |
| RAS use | 1548 | 64.9 | 0.48 | 0.30 to 0.77 | 0.002 | 1631 | 53.6 | 0.72 | 0.58 to 0.88 | 0.002 |
| Enrolment location | ||||||||||
| CHW | 96 | 43.8 | Ref. | 3745 | 57.9 | |||||
| PHC | 2008 | 68.0 | 4.85 | 1.22 to 19.25 | 0.02 | 0 | NA | NA | ||
| CNS danger sign† | ||||||||||
| No | 678 | 78.5 | Ref. | 425 | 62.8 | Ref. | ||||
| Yes | 1426 | 61.4 | 0.58 | 0.41 to 0.82 | 0.002 | 3320 | 57.3 | 0.80 | 0.61 to 1.04 | 0.09 |
| Enrolled during rainy season‡ | ||||||||||
| No | 959 | 69.3 | Ref. | 1392 | 55.5 | Ref. | ||||
| Yes | 1145 | 64.9 | 0.77 | 0.56 to 1.07 | 0.12 | 2353 | 59.4 | 1.15 | 0.97 to 1.38 | 0.11 |
| Enrolled on a workday | ||||||||||
| No | 527 | 69.3 | Ref. | 959 | 53.8 | Ref. | ||||
| Yes | 1577 | 66.1 | 0.91 | 0.65 to 1.29 | 0.60 | 2786 | 59.4 | 1.19 | 1.00 to 1.41 | 0.05 |
| Enrolled during COVID-19 pandemic | ||||||||||
| No | 1638 | 66.7 | Ref. | 3323 | 57.8 | Ref. | ||||
| Yes | 466 | 67.8 | 1.15 | 0.78 to 1.70 | 0.48 | 422 | 58.8 | 0.90 | 0.69 to 1.19 | 0.48 |
| Delay to enrolling provider | ||||||||||
| 0–1 days | 667 | 60.3 | Ref. | 2134 | 56.8 | Ref. | ||||
| >1 day | 1336 | 68.5 | 1.07 | 0.77 to 1.49 | 0.69 | 1565 | 59.1 | 1.14 | 0.97 to 1.34 | 0.12 |
| Missing | 101 | 90.1 | 3.33 | 0.86 to 12.83 | 0.08 | 46 | 71.7 | 1.11 | 0.43 to 2.86 | 0.83 |
| Transport to enrolling provider | ||||||||||
| No vehicle | 1691 | 63.0 | Ref. | 3462 | 57.8 | Ref. | ||||
| Vehicle | 307 | 81.8 | 1.08 | 0.66 to 1.79 | 0.75 | 260 | 57.7 | 1.06 | 0.78 to 1.42 | 0.72 |
| Missing | 106 | 86.8 | 4.80 | 1.37 to 16.84 | 0.01 | 23 | 78.3 | 3.31 | 0.78 to 14.06 | 0.11 |
| Time to referral health facility (min) | ||||||||||
| 0–<15 | 806 | 82.9 | Ref. | 1998 | 67.5 | Ref. | ||||
| 15–<30 | 322 | 72.0 | 1.12 | 0.65 to 1.95 | 0.68 | 1457 | 47.5 | 0.72 | 0.58 to 0.89 | 0.003 |
| 30–<60 | 336 | 67.9 | 0.80 | 0.46 to 1.40 | 0.44 | 270 | 42.6 | 0.55 | 0.39 to 0.79 | 0.001 |
| ≥60 | 228 | 35.1 | 0.46 | 0.24 to 0.89 | 0.02 | 2 | 0.0 | NA | ||
| Missing | 412 | 48.5 | 0.87 | 0.52 to 1.46 | 0.60 | 18 | 77.8 | 1.88 | 0.53 to 6.67 | 0.33 |
| Perceived severity | ||||||||||
| Not fatal | 1542 | 63.5 | Ref. | 2078 | 56.8 | Ref. | ||||
| Fatal | 545 | 75.8 | 1.86 | 1.28 to 2.71 | 0.001 | 1657 | 59.4 | 1.11 | 0.94 to 1.30 | 0.21 |
| Missing | 17 | 94.1 | 16.14 | 0.61 to 429.60 | 0.10 | 10 | 50.0 | 0.80 | 0.20 to 3.19 | 0.75 |
| Home treatment | ||||||||||
| No | 793 | 56.1 | Ref. | 3271 | 57.4 | Ref. | ||||
| Yes | 1311 | 73.5 | 1.43 | 1.03 to 1.99 | 0.03 | 474 | 62.0 | 1.10 | 0.87 to 1.39 | 0.41 |
| Missing | 0 | NA | NA | 0 | NA | NA | ||||
*OR additionally adjusted for child sex, child age, caregiver sex, caregiver age, location of residence (health zone, district) and malaria test result.
†Danger signs involving the CNS: convulsions, unusually sleepy or unconscious.
‡DRC: October–April; Uganda: April–October.
§Denominator.
CHW, community health worker; CNS, central nervous system; DRC, Democratic Republic of the Congo; PHC, primary health centre; RAS, rectal artesunate.