ArticlePloS one2014
Correlates of inappropriate prescribing of antibiotics to patients with malaria in Uganda.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Epidemiology of community-acquired pneumonia and implications for vaccination of children living in developing and newly industrialized countries: A systematic literature review.Human vaccines & immunotherapeutics · 2016Pooled it
- Comparison of commercially available, rapid, point-of-care C-reactive protein assays among children with febrile illness in southwestern Uganda.PLOS global public health · 2024Article
- Perspective on the Integration of Diagnostic Algorithms for Fever Management.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Levels and determinants of overprescribing of antibiotics in the public and private primary care sectors in South Africa.BMJ global health · 2023Article
- Characterising paediatric mortality during and after acute illness in Sub-Saharan Africa and South Asia: a secondary analysis of the CHAIN cohort using a machine learning approach.EClinicalMedicine · 2023Article
- Antimicrobial use related problems and determinants in surgical ward of Ethiopian tertiary hospital.PloS one · 2023Observational
- Differences in diagnosis, management, and outcomes of acute febrile illness by health facility level in southern Ethiopia.Scientific reports · 2022Article
- Antimicrobial Stewardship in Tropical Infectious Diseases: Focusing on Dengue and Malaria.Tropical medicine and infectious disease · 2022Review
- Clinical management and outcomes of acute febrile illness in children attending a tertiary hospital in southern Ethiopia.BMC infectious diseases · 2022Article
- An Evaluation of Antibiotic Prescription Rationality at Lower Primary Healthcare Facilities in Three Districts of South-Western Uganda.Journal of multidisciplinary healthcare · 2022Article
- Rapid Diagnostic Tests to Guide Case Management of and Improve Antibiotic Stewardship for Pediatric Acute Respiratory Illnesses in Resource-Constrained Settings: a Prospective Cohort Study in Southwestern Uganda.Microbiology spectrum · 2021Observational
- An Evaluation of Antibiotic Prescribing Practices in a Rural Refugee Settlement District in Uganda.Antibiotics (Basel, Switzerland) · 2021Article
- Determinants for the use and de-implementation of low-value care in health care: a scoping review.Implementation science communications · 2021Article
- A mixed method multi-country assessment of barriers to implementing pediatric inpatient care guidelines.PloS one · 2019Article
- Drug use in the management of uncomplicated malaria in public health facilities in the Democratic Republic of the Congo.Malaria journal · 2018Article
- Quality of care in integrated community case management services in Bugoye, Uganda: a retrospective observational study.Malaria journal · 2018Observational
- Challenges in implementing uncomplicated malaria treatment in children: a health facility survey in rural Malawi.Malaria journal · 2017Article
- Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn many rural areas of Uganda, febrile patients presenting to health facilities are prescribed both antimalarials and antibiotics, contributing to the overuse of antibiotics. We identified the prevalence and correlates of inappropriate antibiotic management of patients with confirmed malaria.
methodsWe utilized individual outpatient data from 36 health centers from January to September 2011. We identified patients who were prescribed antibiotics without an appropriate clinical indication, as well as patients who were not prescribed antibiotics when treatment was clinically indicated. Multivariate logistic regression models were used to identify clinical and operational factors associated with inappropriate case management.
findingsOf the 45,591 patients with parasitological diagnosis of malaria, 40,870 (90%) did not have a clinical indication for antibiotic treatment. Within this group, 17,152 (42%) were inappropriately prescribed antibiotics. The odds of inappropriate prescribing were higher if the patient was less than five years old (aOR 1.96, 95% CI 1.75-2.19) and if the health provider had the fewest years of training (aOR 1.86, 95% CI 1.05-3.29). The odds of inappropriate prescribing were lower if patients had emergency triage status (aOR 0.75, 95% CI 0.59-0.96) or were HIV positive (aOR 0.31, 95% CI 0.20-0.45). Of the 4,721 (10%) patients with clinical indications for antibiotic treatment, 521 (11%) were inappropriately not prescribed antibiotics. Clinical officers were less likely than medical officers to inappropriately withhold antibiotics (aOR 0.54, 95% CI 0.29-0.98).
conclusionOver 40% of the antibiotic treatment in malaria positive patients is prescribed despite a lack of documented clinical indication. In addition, over 10% of patients with malaria and a clinical indication for antibiotics do not receive them. These findings should inform facility-level trainings and interventions to optimize patient care and slow trends of rising antibiotic resistance.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.