“Referral patterns and associated factors among adult patients admitted with Severe Malaria at Shedeho Meket Primary Hospital, Northeast Ethiopia”

INTRODUCTION: Malaria is a protozoan disease transmitted by the bite of infected female Anopheles mosquitoes, with severe and fatal cases predominantly caused by Plasmodium falciparum. Despite a lower prevalence compared to other endemic African nations, malaria remains a significant public health challenge in Ethiopia. This study aimed to assess the referral patterns and associated factors among adult patients admitted with severe malaria at Shedeho Meket Primary Hospital in Northeast Ethiopia. METHODS: An institution-based retrospective cross-sectional study was conducted at Shedeho Meket Primary Hospital. Data were extracted from the medical records of adult patients admitted with severe malaria over a two-year period, from April 2023 to April 2025. Data were analyzed using SPSS v27. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with referral decisions, with results reported as Adjusted Odds Ratios (AOR) at p < 0.05 with 95% confidence intervals. RESULT: Out of 165 patients with severe malaria admitted from April 2023 to April 2025, 94 (57.0%) were males and 71 (43.0%) were females. The mean age was 34.44 (± 15.312 SD). Of the 165 participants, 151 (91.5%) recovered, while 23 (13.94%) were referred to other healthcare facilities. No deaths were reported due to severe malaria. The significant associations between hyperparasitemia (adjusted odds ratio (AOR) = 2.083 (95% CI; 0.019-7.803)), severe malarial anemia (AOR = 3.052 (95% CI; 2.066-13.232)), and significant bleeding (AOR = 8.012 (95% CI; 2.066-21.232)) with referral decisions highlight the importance of early detection and intervention. CONCLUSION: This study showed that even in fewer areas where malaria is prevalent, severe malaria is a substantial burden, necessitating greater attention. The study observed most of the WHO severity indicators, with the exception of jaundice, convulsion, and pulmonary edema. The significant associations between severe anemia, significant bleeding, and hyperparasitemia with referral decisions highlight the importance of early detection and intervention.