ArticlePloS one2015
Malaria care in infants aged under six months in Uganda: an area of unmet needs!
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 13 citations in OpenAlex.
- Natural History and the Burden of Malaria During the First Year of Life in the High-Transmission Setting of Uganda.The American journal of tropical medicine and hygiene · 2026Article
- Pharmacokinetics, safety and efficacy of an optimized dose of artemether-lumefantrine in the treatment of acute uncomplicated Plasmodium falciparum malaria in neonates and infants of less than 5 kg body weight: a multicentre, open-label, single-arm phase 2/3 study (CALINA).Tropical medicine and health · 2025Article
- Physiologically based pharmacokinetic modelling to predict artemether and lumefantrine exposure in neonates weighing less than 5 kg treated with artemether-lumefantrine to supplement the clinical data from the CALINA study.Tropical medicine and health · 2025Article
- Use of population pharmacokinetic-pharmacodynamic modelling to inform antimalarial dose optimization in infants.British journal of clinical pharmacology · 2025Review
- Development and application of a PBPK modeling strategy to support antimalarial drug development.CPT: pharmacometrics & systems pharmacology · 2023Article
- Plasmodium falciparum infection and disease in infancy associated with increased risk of malaria and anaemia in childhood.Malaria journal · 2023Article
- Factors influencing health workers' compliance with outpatient malaria 'test and treat' guidelines during the plateauing performance phase in Kenya, 2014-2016.Malaria journal · 2022Article
- Trends in health workers' compliance with outpatient malaria case-management guidelines across malaria epidemiological zones in Kenya, 2010-2016.Malaria journal · 2020Article
- Malaria incidence and prevalence during the first year of life in Nanoro, Burkina Faso: a birth-cohort study.Malaria journal · 2018Article
- Understanding Unlicensed Drug Vendor Practices Related to Childhood Malaria in One Rural District of Uganda: An Exploratory Study.Journal of tropical medicine · 2018Article
- Malaria trends in Silt'i district from 2009-2015 and current childhood malaria in K'ibbet hospital, south-central Ethiopia.MalariaWorld journal · 2017Article
- Malaria investigation and treatment of children admitted to county hospitals in western Kenya.Malaria journal · 2016Article
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundLittle information exists on malaria burden, artemisinin-based combination therapy (ACT) use, and malaria care provided to infants under six months of age. The perception that malaria may be rare in this age group has led to lack of clinical trials and evidence-based treatment guidelines. The objective of this study was to identify malaria parasitemia positivity rate (MPPR) among patients under six months, and practices and predictors of malaria diagnosis and treatment in this population.
methodsCross-sectional data collected from October 2010 to September 2011 on 25,997 individual outpatients aged <6 months from 36 health facilities across Uganda were analysed.
findingsMalaria was suspected in 18,415 (70.8%) patients, of whom 7,785 (42.3%) were tested for malaria. Of those tested, the MPPR was 36.1%, with 63.9% testing negative, of which 1,545 (31.1%) were prescribed an antimalarial. Among children <5kgs, off-label prescription of ACT was high (104/285, 36.5%). Younger age (1-6 days, aOR=0.47, p=0.01; 7-31 days, aOR=0.43, p<0.001; and 1-2 months, aOR=0.61, p<0.001), pneumonia (aOR=0.78, p=0.01) or cough/cold (aOR=0.65, p<0.001) diagnosis, and fever (aOR=0.56, p=0.01) reduced the odds of receiving a malaria test. Fever (aOR=2.22, p<0.001), anemia diagnosis (aOR=3.51, p=0.01), consulting midwives (aOR=3.58, p=0.04) and other less skilled providers (aOR=4.75, p<0.001) relative to medical officers, consulting at hospitals (aOR=3.31, p=0.03), visiting health facilities in a medium-high malaria transmission area (aOR=2.20, p<0.001), and visiting during antimalarial (aOR=1.82, p=0.04) or antibiotic (aOR=2.23, p=0.04) shortages increased the odds of prescribing an antimalarial despite a negative malaria test result.
conclusionsWe found high malaria suspicion but low testing rates in outpatient children aged <6 months. Among those tested, MPPR was high. Despite a negative malaria test result, many infants were prescribed antimalarials. Off-label ACT prescription was common in children weighing <5kgs. Evidence-based malaria guidelines for infants weighing <5 kilograms and aged <6 months are urgently needed.
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