Estimated associations between selected factors and referral completion in Nigeria
| Nigeria | |||||
| N* | Referral completion (%) | Adjusted OR** | 95% CI | P value | |
| All | 600 | 47.8 | |||
| Study group by enrolment location | |||||
| CHW | |||||
| Pre-RAS | 148 | 6.1 | Ref. | ||
| Post-RAS | |||||
| No RAS use | 76 | 21.1 | 3.97 | 1.07 to 14.75 | 0.04 |
| RAS use | 91 | 26.4 | 9.95 | 2.71 to 36.58 | <0.001 |
| PHC† | |||||
| Pre-RAS | 58 | 79.3 | Ref. | ||
| Post-RAS | |||||
| No RAS use | 107 | 95.3 | 35.09 | 6.52 to 188.75 | <0.001 |
| RAS use | 120 | 75.0 | 6.45 | 1.62 to 25.67 | 0.01 |
| Enrolment location | |||||
| CHW | 315 | 15.6 | Ref. | ||
| PHC† | 285 | 83.5 | 19.79 | 2.97 to 131.71 | 0.002 |
| CNS involvement‡ | |||||
| No | 99 | 33.3 | Ref. | ||
| Yes | 501 | 50.7 | 0.48 | 0.17 to 1.38 | 0.17 |
| Enrolled during rainy season§ | |||||
| No | 154 | 50.6 | Ref. | ||
| Yes | 446 | 46.9 | 0.70 | 0.29 to 1.67 | 0.42 |
| Enrolled on a workday | |||||
| No | 107 | 30.8 | Ref. | ||
| Yes | 493 | 51.5 | 0.74 | 0.31 to 1.76 | 0.50 |
| Enrolled during COVID-19 pandemic | |||||
| No | 483 | 49.5 | Ref. | ||
| Yes | 117 | 41.0 | 0.09 | 0.03 to 0.26 | <0.001 |
| Delay to enrolling provider | |||||
| 0–1 days | 197 | 45.7 | Ref. | ||
| >1 day | 327 | 47.1 | 1.64 | 0.77 to 3.52 | 0.20 |
| Missing | 76 | 56.6 | 3.53 | 1.03 to 12.09 | 0.04 |
| Transport to enrolling provider | |||||
| No vehicle/missing¶ | 371 | 33.7 | Ref. | ||
| Vehicle | 229 | 70.7 | 0.82 | 0.32 to 2.10 | 0.68 |
| Time to referral health facility (min) | |||||
| 0–<15 | 104 | 81.7 | Ref. | ||
| 15–<30 | 87 | 71.3 | 0.48 | 0.13 to 1.73 | 0.26 |
| 30–<60 | 149 | 55.7 | 0.23 | 0.07 to 0.77 | 0.02 |
| ≥60 | 247 | 19.4 | 0.06 | 0.02 to 0.22 | <0.001 |
| Missing | 13 | 69.2 | 0.13 | 0.01 to 1.84 | 0.13 |
| Perceived severity | |||||
| Not fatal | 434 | 48.8 | Ref. | ||
| Fatal | 161 | 44.7 | 0.63 | 0.30 to 1.32 | 0.23 |
| Missing | 5 | 60.0 | 1.23 | 0.01 to 153.00 | 0.93 |
| Home treatment | |||||
| No/missing¶ | 379 | 43.8 | Ref. | ||
| Yes | 221 | 54.8 | 1.08 | 0.54 to 2.16 | 0.82 |
*OR additionally adjusted for child sex, child age, caregiver sex, caregiver age, location of residence (LGA) and malaria test result.
†Adjusted for LGA. OR shown for Mayo-Belwa. ORs for Fufore and Song are higher.
‡Danger signs involving the CNS: convulsions, unusually sleepy or unconscious.
§May–October.
¶Observations with missing values added to reference category because no meaningful OR could be computed due to the data structure (missing values in other covariates).
**Denominator.
CHW, community health worker; CNS, central nervous system; PHC, primary health centre; RAS, rectal artesunate.