UGANDA MALARIA SURVEILLANCE PROJECT Mulago Hospital Complex, P.O.Box 7475, Kampala, Tel , Fax ;

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1 UCSF UGANDA MALARIA SURVEILLANCE PROJECT Mulago Hospital Complex, P.O.Box 7475, Kampala, Tel , Fax ; Inpatient Surveillance Monthly Report September 2011 Introduction The Uganda Malaria Surveillance Project (UMSP) was formed in 2001 as a collaboration between researchers at the Makerere University-University of California San Francisco research collaboration and the Ministry of Health. Although Uganda s Health Management Information System (HMIS) remains the primary source of morbidity and mortality data, there are several limitations to this data. To address some of these limitations, UMSP started an inpatient health facility-based surveillance system in different epidemiological settings. The program began in 2010 with the goal of including 6 sentinel district hospitals by July The objective of this surveillance system is to provide accurate and timely data on morbidity and mortality patterns among hospitalized children at participating sites to help guide policy makers and other stakeholders. This monthly report is comprised of a table and graphs highlighting indicators of morbidity and mortality including treatment practices at participating sites for a specified month. The table below provides a summary of the total number of hospitalized children per site who fulfil each of the criteria for specified indicators. For each indicator a bar graph allowing for comparison of results across the sites is generated, each bar representative of the results (in proportions) for each site for that particular indicator. A list of definitions of terms used in the report and a table showing the numerators and denominator used to determine the indicators as proportions are included in the Appendix section (last page). Absolute numbers of children hospitalized Hospitalized children under 5 years of age only < 5 Any Clinical Lab Lab confirmed Site Total Any years lab diagnosis of confirmed complicated death test result Lab confirmed death with Tororo Hospital Jinja Hospital Kambuga Hospital Mubende Hospital Apac Hospital Kabale Hospital

2 Data below only includes children under 5 years of age admitted to the hospital Proportion of patients with any diagnostic test result during hospitalization % 98.9% % 98.4% 93.8% Proportion of patients with clinical diagnosis of at discharge % 70.5% 62.5% 54.6% 57.4% 4 6.3% Proportion of patients with laboratory confirmed % 38.9% 28.8% 31.9%

3 Proportion of patients with laboratory confirmed complicated % 30.6% 21.3% 26.1% 26.7% 8. Proportion of patients who died from any cause during hospitalization 15% 12.3% 1 5% 5.1% 4.7% 3.3% 2.5% 1.3% Proportion of patients who died with laboratory confirmed during hospitalization 15% 1 5% 3.4% 1.7% 0.7% % 0.

4 Antil treatment practices based on laboratory testing Any positive laboratory test result None IV Quinine Other antil Only negative laboratory test results None IV Quinine Other antil No laboratory test done None IV Quinine Other antil Too few cases 4

5 Appendix I. Definitions Laboratory confirmed : Any hospitalized child with a positive test (thick blood smear or RDT) result Clinical diagnosis of : Any hospitalized child with a final discharge diagnosis of (confirmed or unconfirmed) as indicated by the clinician. Laboratory confirmed complicated : Any hospitalized child with a positive test result and fulfils any of the following: 1) any criteria for severe. 2) one or more general danger signs (vomiting everything, inability to drink, feed or breastfeed, lethargy or unconscious or convulsions) or 3) dies during hospitalization Indicators expressed as proportions Indicator with diagnostic test result with a clinical diagnosis of with laboratory confirmed children< 5 years of age with complicated who died of any cause who died with Antil treatment practices Definition Numerator: Number of hospitalized with a test result Denominator: Number of hospitalized Numerator: Number of hospitalized with a final diagnosis of Denominator: Number of hospitalized with any final diagnosis Numerator: Number of hospitalized with a positive lab test Denominator: Number of hospitalized with a test result Numerator: Number of hospitalized with + lab test and complicated Denominator: Number of hospitalized with a test result Numerator: Number of hospitalized who died of any cause Denominator: Number of hospitalized with a disposition Numerator: Number of hospitalized who died with a positive lab test Denominator: Number of hospitalized with a test result & disposition Numerator: Number in each treatment category stratified by test results Denominator: Totals for each test results strata