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. 2022 May 17;7(5):e008346. doi: 10.1136/bmjgh-2021-008346

Table 4.

Estimated associations between selected factors and referral completion in Nigeria

Nigeria
N* Referral completion (%) Adjusted OR** 95% CI P value
All 600 47.8
Study group by enrolment location
CHW
Pre-RAS 148 6.1 Ref.
Post-RAS
No RAS use 76 21.1 3.97 1.07 to 14.75 0.04
RAS use 91 26.4 9.95 2.71 to 36.58 <0.001
PHC†
Pre-RAS 58 79.3 Ref.
Post-RAS
No RAS use 107 95.3 35.09 6.52 to 188.75 <0.001
RAS use 120 75.0 6.45 1.62 to 25.67 0.01
Enrolment location
CHW 315 15.6 Ref.
PHC† 285 83.5 19.79 2.97 to 131.71 0.002
CNS involvement‡
No 99 33.3 Ref.
Yes 501 50.7 0.48 0.17 to 1.38 0.17
Enrolled during rainy season§
No 154 50.6 Ref.
Yes 446 46.9 0.70 0.29 to 1.67 0.42
Enrolled on a workday
No 107 30.8 Ref.
Yes 493 51.5 0.74 0.31 to 1.76 0.50
Enrolled during COVID-19 pandemic
No 483 49.5 Ref.
Yes 117 41.0 0.09 0.03 to 0.26 <0.001
Delay to enrolling provider
0–1 days 197 45.7 Ref.
>1 day 327 47.1 1.64 0.77 to 3.52 0.20
Missing 76 56.6 3.53 1.03 to 12.09 0.04
Transport to enrolling provider
No vehicle/missing¶ 371 33.7 Ref.
Vehicle 229 70.7 0.82 0.32 to 2.10 0.68
Time to referral health facility (min)
0–<15 104 81.7 Ref.
15–<30 87 71.3 0.48 0.13 to 1.73 0.26
30–<60 149 55.7 0.23 0.07 to 0.77 0.02
≥60 247 19.4 0.06 0.02 to 0.22 <0.001
Missing 13 69.2 0.13 0.01 to 1.84 0.13
Perceived severity
Not fatal 434 48.8 Ref.
Fatal 161 44.7 0.63 0.30 to 1.32 0.23
Missing 5 60.0 1.23 0.01 to 153.00 0.93
Home treatment
No/missing¶ 379 43.8 Ref.
Yes 221 54.8 1.08 0.54 to 2.16 0.82

*OR additionally adjusted for child sex, child age, caregiver sex, caregiver age, location of residence (LGA) and malaria test result.

†Adjusted for LGA. OR shown for Mayo-Belwa. ORs for Fufore and Song are higher.

‡Danger signs involving the CNS: convulsions, unusually sleepy or unconscious.

§May–October.

¶Observations with missing values added to reference category because no meaningful OR could be computed due to the data structure (missing values in other covariates).

**Denominator.

CHW, community health worker; CNS, central nervous system; PHC, primary health centre; RAS, rectal artesunate.