title: Treatment practices in patients with suspected malaria in Provincial Hospital of Tete, Mozambique.
abstract: BACKGROUND
  Nowadays, parasite-based diagnosis by microscopy or malaria rapid diagnostic tests (RDT) is universally promoted before malaria treatment. However, studies on adherence of primary caregivers to malaria test results have provided conflicting results.
  
  
  METHODS
  The antimalarial and antibiotic prescription rates in patients with suspected malaria at Provincial Hospital of Tete, Mozambique, and the features associated with antibiotic prescription in non-severely ill parasite-negative patients were assessed.
  
  
  RESULTS
  In March and April 2010, Plasmodium falciparum malaria was diagnosed by microscopy or RDT in 728 (27.2%) of 2672 patients tested. Almost all malaria patients were prescribed antimalarials and 20% were also given antibiotics. Of 1944 parasite-negative patients, 126 (6.5%) were prescribed antimalarials and 1213 (62.4%) antibiotics. Among non-severely ill parasite-negative patients with complete information (n = 1607), the antibiotic prescription rate was 68.8% and was more frequent with respiratory symptoms and leukocyte counts >10 000/μL (adjusted OR = 1.62, 95% CI 1.18-2.23 and adjusted OR = 2.12, 95% CI 1.66-2.71, respectively).
  
  
  CONCLUSIONS
  Adherence to malaria test results was good in this reference setting, but antibiotic prescription was relatively frequent in clinically stable non-malaria patients. Optimal management of parasite-negative patients must be further defined along with programmatic deployment of the parasite-based strategy.
authors: Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium. ebottieau@itg.be
authors: E
authors: E
authors: Bottieau
authors: P
authors: P
authors: Gillet
authors: A
authors: A
authors: De Weggheleire
authors: A
authors: A
authors: Scheirlinck
authors: J
authors: J
authors: Stokx
authors: C
authors: C
authors: Das Dores Mosse
authors: J
authors: J
authors: Jacobs
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000962:Antimalarials / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D009073:Mozambique; D015999:Multivariate Analysis; D010818:Practice Patterns, Physicians'; D055656:Prescriptions / Q000706:statistics & numerical data
chemical_list: D000900:Anti-Bacterial Agents; D000962:Antimalarials