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dc.contributor.authorChang, Jonathan L.
dc.contributor.authorReyes, Raquel
dc.contributor.authorMatte, Michael
dc.contributor.authorNtaro, Moses
dc.contributor.authorMulogo, Edgar
dc.contributor.authorWiens, Matthew O.
dc.contributor.authorMeshnick, Steven R.
dc.contributor.authorSiedner, Mark J.
dc.contributor.authorBoyce, Ross M.
dc.date.accessioned2022-09-16T13:55:17Z
dc.date.available2022-09-16T13:55:17Z
dc.date.issued2018
dc.identifier.citationChang, J. L., Reyes, R., Matte, M., Ntaro, M., Mulogo, E., Wiens, M. O., ... & Boyce, R. M. (2018). Who stays and who goes: predictors of admission among patients presenting with febrile illness and a positive malaria rapid diagnostic test in a rural Ugandan health center. The American journal of tropical medicine and hygiene, 99(4), 1080.en_US
dc.identifier.urihttp://ir.must.ac.ug/xmlui/handle/123456789/2484
dc.description.abstractNot much is known about clinical decision-making in rural, low-resource settings regarding fever, a common reason for presentation to care. In this prospective cohort study of patients presenting with febrile illness to a rural Ugandan health center, we examined demographic and clinical factors predictive of an initial disposition of inpatient admission after clinical evaluation, but before laboratory testing. We then assessed the association of laboratory results and system factors with a change between initial and final disposition plans. Four thousand nine hundred twenty-four patients with suspected febrile illness were included in the primary analysis. The strongest predictors for an initial disposition of admission after clinical examination were impaired consciousness (adjusted risk ratio [aRR], 3.21; 95% confidence interval [CI]: 2.44–4.21) and fever on examination (aRR, 2.27; 95% CI: 1.79–2.87). Providers initially planned to discharge patients with significant vital sign abnormalities, including tachypnea (3.6%) and hypotension (1.3%). Anemia strongly predicted a final disposition of admission after an initial disposition of discharge (aRR, 48.34; 95% CI: 24.22–96.49); other laboratory abnormalities, including hypoglycemia and acidosis, did not change disposition planning. In those with an initial disposition of admission, living farther than the two neighboring villages was associated with a final disposition of discharge (aRR, 2.12; 95% CI: 1.10–4.12). A concerning number of patients with abnormal vital signs and laboratory results were not admitted for inpatient care. Geographic factors may influence a patient’s final disposition contrary to a provider’s initial disposition plan. Future work should assess longer term outcomes after discharge and a broader study population.en_US
dc.language.isoen_USen_US
dc.publisherThe American journal of tropical medicine and hygieneen_US
dc.subjectPredictorsen_US
dc.subjectPatientsen_US
dc.subjectMalariaen_US
dc.subjectDiagnosisen_US
dc.subjectTesten_US
dc.subjectUgandaen_US
dc.titleWho Stays and Who Goes: Predictors of Admission among Patients Presenting with Febrile Illness and a Positive Malaria Rapid Diagnostic Test in a Rural Ugandan Health Centeren_US
dc.typeArticleen_US


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