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Table 4 Predictors of malaria overtreatment (prescription of ACT to patients without confirmed malaria) (N = 1,390)

From: Patient-, health worker-, and health facility-level determinants of correct malaria case management at publicly funded health facilities in Malawi: results from a nationally representative health facility survey

   Unadjusted prevalence ratio Confidence interval p-value Adjusted prevalence ratio Confidence interval p-value
Patient Male sex 1.27 [1.00, 1.60] 0.046 1.10 [0.92, 1.30] 0.276
Spontaneous complaint to provider of:       
  Fever 2.64 [2.08, 3.33] <0.0001 2.10 [1.71, 2.58] <0.0001
  Cough 1.18 [0.90, 1.56] 0.233    
  Vomiting 1.74 [1.28, 2.38] 0.001 1.43 [1.20, 1.71] <0.0001
  Chills 1.67 [1.32, 2.12] <0.0001 1.66 [1.34, 2.04] <0.0001
  Fatigue 0.35 [0.13, 0.93] 0.036 0.38 [0.19, 0.77] 0.008
Age <5 years 1.82 [1.30, 2.57] 0.001 1.13 [0.91, 1.41] 0.258
High temperature (≥37.5°C) according to exit interview 1.87 [1.52, 2.29] <0.0001 1.37 [1.13, 1.66] 0.001
Health provider Female health worker 1.32 [0.86, 2.03] 0.20    
Type of clinician       
  Medical officer/doctor/clinical officer [Reference] [Reference] [Reference]    
  Medical assistant 3.75 [0.93, 15.16] 0.063 3.63 [0.93, 14.17] 0.063
  Nurse 4.39 [1.01, 19.06] 0.048 3.99 [0.98, 16.24] 0.053
Copy of current malaria treatment guidelines 0.86 [0.60, 1.24] 0.424    
Malaria-specific training 1.20 [0.70, 2.06] 0.514    
Supervision in previous 6 months 0.89 [0.53, 1.48] 0.653    
Health facility Type of facility       
  District hospital [Reference] [Reference] [Reference]    
  Health centre 3.21 [0.95, 10.92] 0.061    
  Community hospital 2.16 [0.60, 7.78] 0.234    
AL in stock for full day 0.87 [0.55, 1.40] 0.572    
Thermometer present 1.02 [0.60, 1.73] 0.940    
Functional microscopy 0.76 [0.44, 1.30] 0.311    
CHAM-operated facility 1.31 [0.83, 2.07] 0.242    
Region Region       
  Northern [Reference] [Reference] [Reference]    
  Central 1.26 [0.63, 2.52] 0.515    
    Southern 1.28 [0.78, 2.10] 0.328