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Table 3 Definitions used to categorise delayed presentations

From: Delayed presentation to hospital care is associated with sequelae but not mortality in children with cerebral malaria in Malawi

Institutional delay

The time taken for patients to reach the PRW from nationwide referral routes; local health centres, private clinics, district hospitals, Accident and Emergency, the Paediatric Special Care Ward, and other departments of QECH. This included the actions of health workers involved in the treatment and handling of patients prior to their arrival at the PRW, as well as protocol time and ambulance availability

Family action

The decisions made by the patients’ parent or guardian. These were often made based on the hope that the child would improve on their own or due to misinterpretation of the severity of their condition, sometimes believing they were “just sleeping”

Transport problems

In cases where patients lived in remote, rural areas, the lack of transport, lack of money for transport or sheer distance to travel to find transport were notable impeding factors


The clinical notes did not detail (or the parent or guardian did not tell) the exact reason for delay in arrival at the PRW