Photoproduction of Long-Lived Holes and Electronic Processes in Intrinsic Electric Fields Seen through Photoinduced Absorption and Dichroism in Ca_3Ga_{2-x}Mn_xGe_3O_{12} Garnets

Long-lived photoinduced absorption and dichroism in the Ca_3Ga_{2-x}Mn_xGe_3O_{12} garnets with x < 0.06 were examined versus temperature and pumping intensity. Unusual features of the kinetics of photoinduced phenomena are indicative of the underlying electronic processes. The comparison with the case of Ca_3Mn_2Ge_3O_{12}, explored earlier by the authors, permits one to finally establish the main common mechanisms of photoinduced absorption and dichroism caused by random electric fields of photoproduced charges (hole polarons). The rate of their diffusion and relaxation through recombination is strongly influenced by the same fields, whose large statistical straggling is responsible for a broad continuous set of relaxation components (observed in the relaxation time range from 1 to about 1000 min). For Ca_3Ga_{2-x}Mn_xGe_3O_{12}, the time and temperature dependences of photoinduced absorption and dichroism bear a strong imprint of structure imperfection increasing with x.Comment: 20 pages, 10 figure

The Peculiarities of Six-Minute Walk Test in Patients with Chronic Obstructive Pulmonary Disease, Some with Normal Weight and Some Overweight

Background: The combination of chronic obstructive pulmonary disease (COPD) and overweight/obesity is a common clinical situation in modern healthcare. The objective of this study was to conduct a comparative analysis of exercise tolerance in normal body weight (NBW) and overweight patients with COPD in the 6MWT using the original device for cardiorespiratory analysis and a method for assessing the cardiorespiratory condition. Methods and Results: The study included 194 patients with COPD. The patients were divided into two groups. Group 1 consisted of 96 COPD patients with NBW: 77(80.21%) men and 19(19.79%) women aged 41 to 73 years (mean age of 63.33 ± 8.44 years). Group 2 consisted of 98 overweight COPD patients: 74(75.51%) men and 24(24.49%) women aged 55 to 71 (mean age of 64.84 ± 5.46 years). To assess tolerance to physical activity and to objectify the functional status of patients, the 6MWT was used and carried out according to generally accepted principles. The distance covered in 6 minutes (6MWD) was measured in meters and compared with the proper 6MWD(i). The developed device for cardiorespiratory analysis was used to obtain the most accurate 6MWT result. All patients in the study groups underwent an analysis of the composition of the body by the bioelectrical impedance method using a fat mass analyzer BC-555 (Tanita Corporation, Tokyo, Japan). The percentages of fat, water, muscle mass (MM), and bone mass were evaluated. The average value of the 6MWD/6MWD(i) ratio in COPD patients with NBW was significantly lower than in COPD patients with overweight (P=0.0121). Before the test, the study groups did not differ in the level of SpO2. However, according to the results of comparative analysis, this parameter was significantly lower in patients with NBW immediately after the 6MWT (P=0.0000), which, along with a lower value of the distance traveled as a percentage of the proper value in Group 1 patients, may indicate a lower tolerance to physical activity in COPD patients with NBW than in patients with overweight. In COPD patients with NBW, the percentage of fat and MM were significantly lower than in COPD patients with overweight (P=0.0000 in both cases). There was a direct correlation between 6MWD and body mass index (r=0.56, P=0.003) and between 6MWD and MM percentage (r=0.59, P=0.016). Conclusion: Higher exercise tolerance is found in overweight COPD patients than in COPD patients with NBW. This phenomenon can be explained to some extent by the compositional components of the body, in particular, by a significantly lower percentage of lean MM in patients with NBW

МОНІТОРИНГ СТАНУ ЗДОРОВ’Я ЗА ФУНКЦІОНАЛЬНИМИ ПОКАЗНИКАМИ ЗА ДОПОМОГОЮ СЕНСОРІВ У РЕАБІЛІТАЦІЙНІЙ МЕДИЦИНІ: СИСТЕМАТИЧНИЙ ОГЛЯД

At present, people’s need for rapid and effective rehabilitation processes is growing significantly. People with limited functional capabilities need sensor devices that are used for rehabilitation in order to improve human health and to return to a decent standard of living. Sensory devices are used for the health monitoring system of people that are divided into portable and movable. After all, rehabilitation treatment requires patients of different age groups with cardio-pulmonary pathology, neurological disorders, orthopedic disorders, etc. The article covers electromechanical, electric, optical and thermal sensors, acoustic signal transducers or sensitive sensors, sensors and their application at different stages of rehabilitation. The aim of the study – to conduct an analysis of modern domestic and foreign literature on types of sensors in rehabilitation medicine. Materials and Methods. The study used biblio-semantic and analytical methods in the following electronic databases: Science Direct, PubMed, Scopus and Google Scholar. When looking for an article, annotations are analyzed. Inclusion criteria were: (1) physical and medical rehabilitation and / or auxiliary system supported by sensors and computer, (2) systems developed for the human body, and (3) documents written in English. If the expected criterion was found, the full text was reviewed. Results and Discussion. During the study, a systematic review and analysis of recent publications, mainly foreign scientific medical, biological and technical literature on the types, principles of work, development and the possibilities of using sensors in rehabilitation medicine was conducted. Sensory technologies continue to be fully developed and offer convenient opportunities to use to improve the functional state of health. A wide range of studies included and reflected in this review included various types of sensors. To date, devices used to monitor physical activity are divided into sensors that measure biological parameters such as pressure, heart rate, respiratory rate - pulse meter, tonometer, spirometer and motion sensors – pedometers, accelerometers, trackers of activity. Some of the most commonly used sensors used in rehabilitation are electromyography, galvanic skin reaction, electrocardiography, electroencephalography and sensory sensors and systems that control motor and physiological activity of a person. The article for examples considered: 1 – a typical algorithm for the operation of devices for monitoring the functional state of human health, 2 – diagnostic tool ALLADIN with sensors, which includes nine components. In the electronic databases: Science Direct, PubMed, Scopus and Google Scholar, no previously published work was found whereby the authors synthesized a combination of sensors with hardware, robotic, computer, and rehabilitation systems for patients of different ages. Conclusions. In the analysis of modern domestic and foreign literature on types of sensors in rehabilitation medicine, the development and application of sensor devices in physical and medical rehabilitation has been studied and described. All publications indicate that sensory sensors are attached to devices that allow measuring functional performance of a person's health. Therefore, sensory technologies in rehabilitation medicine continue to develop in a comprehensive manner and are frequently used to diagnose, assess and monitor the health of a person.На сегодняшнее время значительно возрастает потребность людей в быстрых и эффективных реабилитационных процессах. Людям с ограниченными функциональными возможностями необходимые сенсорные устройства, которые применяются для реабилитации с целью улучшения здоровья человека и его возвращение к надлежащему качеству жизни. Сенсорные устройства применяются для системы мониторинга здоровья людей, которые подразделяются на портативные и переносные. Ведь реабилитационного лечения требуют пациенты различной возрастной категории с сердечно-легочной патологией, неврологическими расстройствами, ортопедическими нарушениями и тому подобное. В статье освещены электромеханические, электрические, оптические и тепловые сенсоры, преобразователи акустических сигналов или чувствительностью сенсоры, сенсорные датчики и их применения на различных этапах реабилитации. Цель исследования – провести анализ современной отечественной и зарубежной литератур по видам сенсоров в реабилитационной медицине. Материалы и методы. В исследовании применены библиосистематичный и аналитический методы в следующих электронных базах данных: Science Direct, PubMed, Scopus и Google Scholar. При поиске статье проанализированы анотации. Критериями включения были: 1 – физическая и медицинская реабилитация и/или вспомогательная система, которая поддерживается сенсорами и компьютером, 2 – системы, разработанные для организма человека, и 3 – документы, написанные на английском языке. Если ожидаемый критерий был найден, полный текст пересматривался. Результаты исследований и их обсуждение. Во время выполнения исследования был проведен систематический обзор и анализ последних публикаций, в основном зарубежной научной медицинской, логической и технической литературы по видам, принципам работы, разработке и возможностям применения сенсоров в реабилитационной медицине. Сенсорные технологии продолжают всесторонне развиваться и предлагают удобные возможности в использовании для улучшения функционального состояния здоровья. Широкий спектр исследований, включенных и отраженных в данном обзоре, включал различные типы сенсоров. На сегодняшний день устройства, используемые для мониторинга физической активности, разделяют на сенсоры, которые измеряют такие биологические показатели, как давление, частоту сердечных сокращений, частоту дыхания – пульсометр, тонометр, спирометр, и датчики движения – педометры, акселерометры, трекеры активности. Некоторыми из наиболее часто используемых сенсоров, которые применялись в реабилитации, является электромиография, гальваническая реакция кожи, электроэнцефалография, электрофалография и сенсорные датчики и системы, которые конт­ролируют двигательную и физиологическую активность человека. В статье для примеров рассмотрены: 1 – типичный алгоритм работы устройств для мониторинга функционального состояния здоровья человека, 2 – диагностический прибор ALLADIN с сенсорами, который включает девять компонентов. В электронных базах данных: Science Direct, PubMed, Scopus и Google Scholar не найдено ни одной ранее опубликованной работы, где бы авторы обобщали сочетание сенсоров с аппаратными средствами, робототехническими, компьютерными, системами для реабилитации пациентов разных возрастных категорий. Выводы. При анализе современной отечественной и зарубежной литератур по видам сенсоров в реабилитационной медицине изучено и описано развитие и применение сенсорных приборов в физической и медицинской реабилитации. Во всех публикациях указывается, что сенсорные датчики прикрепляются к устройствам, которые позволяют измерять функциональные показатели состояния здоровья человека. Поэтому сенсорные технологии в реабилитационной медицине продолжают всесторонне развиваться и часто используются для диагностики, оценки состояния здоровья человека и его реабилитации.На сьогодні значно зростає потреба людей у швидких та ефективних реабілітаційних процесах. Людям з обмеженими функціональними можливостями необхідні сенсорні пристрої, які застосовують для реабілітації з метою покращення здоров’я людини та її повернення до належного рівня життя. Сенсорні пристрої використовують для системи моніторингу здоров’я людей, які поділяють на портативні та переносні. Адже реабілітаційного лікування потребують пацієнти різної вікової категорії із серцево-легеневою патологією, неврологічними розладами, ортопедичними порушеннями тощо. У статті висвітлено електромеханічні, електричні, оптичні та теплові сенсори, перетворювачі акустичних сигналів або сенсори, чутливі до маси, сенсорні датчики та їх застосування на різних етапах реабілітації. Мета дослідження – проаналізувати сучасну вітчизняну та зарубіжну літератури щодо видів сенсорів у реабілітаційній медицині. Матеріали і методи. У дослідженні застосовано бібліосистематичний та аналітичний методи в наступних електронних базах даних: Science Direct, PubMed, Scopus і Google Scholar. Під час пошуку статті проаналізовано анотації. Критеріями включення були такі: 1 – фізична та медична реабілітація і/або допоміжна система, яка підтримується сенсорами і комп’ютером, 2 – системи, розроблені для організму людини, і 3 – документи, написані англійською мовою. Якщо очікуваний критерій було знайдено, повний текст переглядали. Результати досліджень та їх обговорення. Під час виконання дослідження провели систематичний огляд та аналіз останніх публікацій, в основному зарубіжної наукової медичної, біологічної та технічної літератури щодо видів, принципів роботи, розробки та можливостей застосування сенсорів у реабілітаційній медицині. Сенсорні технології продовжують всебічно розвиватися і пропонують зручні можливості у використанні для поліпшення функціонального стану здоров’я. Широкий спектр досліджень, включених і відображених у цьому огляді, включав різні типи сенсорів. На сьогодні пристрої, що використовують для моніторингу фізичної активності, розділяють на сенсори, які вимірюють такі біологічні показники, як тиск, частоту серцевих скорочень, частоту дихання – пульсометр, тонометр, спірометр, та датчики руху – педометри, акселерометри, трекери активності. Деякими з найчастіших у використанні сенсорів у реабілітації є електроміографія, гальванічна реакція шкіри, електрокардіографія, електроенцефалографія та сенсорні датчики і системи, які контролюють рухову і фізіологічну активність людини. У статті для прикладів розглянуто: 1 – типовий алгоритм роботи пристроїв для моніторингу функціонального стану здоров’я людини, 2 – діагностичний прилад ALLADIN з сенсорами, який включає дев’ять компонентів. В електронних базах даних: Science Direct, PubMed, Scopus і Google Scholar не знайдено жодної роботи, раніше опублікованої, де б автори узагальнювали поєднання сенсорів із апаратними засобами, робототехнічними, комп’ютерними, системами для реабілітації пацієнтів різних вікових категорій. Висновки. При аналізі сучасної вітчизняної та зарубіжної літератур щодо видів сенсорів у реабілітаційній медицині вивчено й описано розвиток і застосування сенсорних приладів у фізичній та медичній реабілітації. В усіх публікаціях вказується, що сенсорні датчики прикріплюються до пристроїв, які дають змогу вимірювати функціональні показники стану здоров’я людини. Тому сенсорні технології у реабілітаційній медицині продовжують всебічно розвиватися і часто застововуються для діагностики, оцінки стану здоров’я людини та її реабілітації

Increased use of malaria rapid diagnostic tests improves targeting of anti-malarial treatment in rural Tanzania: implications for nationwide rollout of malaria rapid diagnostic tests.

ABSTRACT: BACKGROUND: The World Health Organization recommends parasitological confirmation of all malaria cases. Tanzania is implementing a phased rollout of malaria rapid diagnostic tests (RDTs) for routine use in all levels of care as one strategy to increase parasitological confirmation of malaria diagnosis. This study was carried out to evaluated artemisinin combination therapy (ACT) prescribing patterns in febrile patients with and without uncomplicated malaria in one pre-RDT implementation and one post-RDT implementation area. METHODS: A cross-sectional health facility surveys was conducted during high and low malaria transmission seasons in 2010 in both areas. Clinical information and a reference blood film on all patients presenting for an initial illness consultation were collected. Malaria was defined as a history of fever in the past 48 hours and microscopically confirmed parasitaemia. Routine diagnostic testing was defined as RDT or microscopy ordered by the health worker and performed at the health facility as part of the health worker-patient consultation. Correct diagnostic testing was defined as febrile patient tested with RDT or microscopy. Over-testing was defined as a febrile patient tested with RDT or microscopy. Correct treatment was defined as patient with malaria prescribed ACT. Over-treatment was defined as patient without malaria prescribed ACT. RESULTS: A total of 1,247 febrile patients (627 from pre-implementation area and 620 from post-implementation area) were included in the analysis. In the post-RDT implementation area, 80.9% (95% CI, 68.2-89.3) of patients with malaria received recommended treatment with ACT compared to 70.3% (95% CI, 54.7-82.2) of patients in the pre-RDT implementation area. Correct treatment was significantly higher in the post-implementation area during high transmission season (85.9% (95%CI, 72.0-93.6) compared to 58.3% (95%CI, 39.4-75.1) in pre-implementation area (p=0.01). Over-treatment with ACT of patients without malaria was less common in the post-RDT implementation area (20.9%; 95% CI, 14.7-28.8) compared to the pre-RDT implementation area (45.8%; 95% CI, 37.2-54.6) (p<0.01) in high transmission. The odds of overtreatment was significantly lower in post- RDT area (adjusted Odds Ratio (OR: 95%CI) 0.57(0.36-0.89); and much higher with clinical diagnosis adjusted OR (95%CI) 2.24(1.37-3.67) CONCLUSION: Implementation of RDTs increased use of RDTs for parasitological confirmation and reduced over-treatment with ACT during high malaria transmission season in one area in Tanzania. Continued monitoring of the national RDT rollout will be needed to assess whether these changes in case management practices will be replicated in other areas and sustained over time. Additional measures (such as refresher trainings, closer supervisions, etc) may be needed to improve ACT targeting during low transmission seasons

ПРИМЕНЕНИЕ МУЛЬТИМОДАЛЬНОЙ АНЕСТЕЗИИ ПРИ ХИРУРГИЧЕСКИХ ВМЕШАТЕЛЬСТВАХ ПО ПОВОДУ ЗЛОКАЧЕСТВЕННЫХ НОВООБРАЗОВАНИЙ ЛЕГКИХ

Objective. To prove pathogenically the reasonability of multimodal anesthesia in patients with lung cancer to improve the efficacy of pain management.Materials and methods. 74 patients (59 men and 15 women) aged 46 to 60 years with lung cancer were examined and treated. 42 patients (the main group) underwent surgery under multimodal anesthesia accompanied with epidural blockade, and 32 patients (the comparison group) were subjected to a surgical intervention under inhalation and intravenous anesthesia with mechanical ventilation. The surgeries including atypical lung resection, lobectomy and pneumonectomy were performed. In preoperative, intraoperative and early postoperative periods, the systemic hemodynamics parameters were determined; adrenaline, noradrenaline, dopamine, cortisol, insulin and glucose were measured in plasma, and acidbase balance parameters — in arterial blood. Pain intensity was assessed by the visual analog scale. Data processing was carried out using Microsoft Exсel 2000, STATISTICA6.0 and Biostat software. Normality of distribution was assessed by KolmogorovSmirnov test. Since the ordered sample did not follow the normal distribution law, the data are presented as a median (Me) and interquartile amplitude (25 and 75 percentiles).Results. It has been found that the most significant pathogenic factor in patients being operated due to lung cancer under the standard anesthesia is the expressed activation of the sympathoadrenal system due to the impact of surgical stress. This is manifested by disorders of the central hemodynamic parameters, such as metabolism, nociception and oxygen balance. In surgeries carried out under multimodal anesthesia, the minimal changes of basic homeostasis parameters are registered; these changes are shorttermed, compensated and reversible. Pain syndrome upon completion of surgery and in the early postoperative period is either absent or mild.Conclusion. It is more expedient to perform surgeries to remove malignant tumors in the lungs under the multimodal anesthesia, because these interventions are distinguished by high traumatic rate and having a «fine line» between compensation and decompensation of the basic vital functions in the perioperative period.Цель исследования — патогенетически обосновать целесообразность использования мультимодальной анестезии у больных со злокачественными новообразованиями легких для повышения эффективности обезболивания.Материалы и методы. Обследовано и пролечено 74 пациента (59 мужчин и 15 женщин) в возрасте от 46 до 60 лет со злокачественными новообразованиями легких. 42 пациента (основная группа) были оперированы в условиях мультимодальной анестезии с эпидуральной блокадой, а 32 пациента (группа сравнения) — в условиях ингаляционновнутривенной анестезии с ИВЛ. Выполнены следующие виды оперативного лечения: атипичная резекция легкого, лобэктомия и пневмонэктомия. В дооперационном, интраоперационном и раннем послеоперационном периоде исследовали параметры системной гемодинамики, определяли в плазме крови содержание адреналина, норадреналина, дофамина, кортизола, инсулина и глюкозы, а в артериальной крови — параметры кислотноосновного состояния. С помощью визуальноаналоговой шкалы оценивали интенсивность боли. Статистическую обработку результатов проводили с использованием программ Microsoft Exсel 2000, Statistica 6,0 и Biostat. Нормальность распределения оценивали с помощью критерия КолмогороваСмирнова. Поскольку вариационный ряд не подчинялся закону нормального распределения, данные представлены в виде медианы (Ме) и интерквартильного размаха (25 и 75 перцентили).Результаты. Установлено, что важнейшим патогенетическим фактором, вызывающим у пациентов, оперированных по поводу злокачественных новообразований легких в условиях стандартного обезболивания, является выраженная активация симпатоадреналовой системы вследствие воздействия хирургического стресса. Это проявляется нарушениями параметров центральной гемодинамики, метаболизма, ноцицепции и кислородного баланса организма. При операциях, выполненных в условиях мультимодальной анестезии, выявляются минимальные изменения основных параметров гомеостаза, имеющие краткосрочный, компенсированный и обратимый характер. Болевой синдром по окончании операции и в раннем послеоперационном периоде либо отсутствует, либо характеризуется как слабовыраженный.Заключение. Операции по удалению злокачественных новообразований легких, отличающиеся высокой травматичностью и имеющие «тонкую грань» между компенсацией и декомпенсацией основных витальных функций в периоперационном периоде, целесообразнее проводить в условиях мультимодальной анестезии

Clinical Performance of an Automated Reader in Interpreting Malaria Rapid Diagnostic Tests in Tanzania.

Parasitological confirmation of malaria is now recommended in all febrile patients by the World Health Organization (WHO) to reduce inappropriate use of anti-malarial drugs. Widespread implementation of rapid diagnostic tests (RDTs) is regarded as an effective strategy to achieve this goal. However, the quality of diagnosis provided by RDTs in remote rural dispensaries and health centres is not ideal. Feasible RDT quality control programmes in these settings are challenging. Collection of information regarding diagnostic events is also very deficient in low-resource countries. A prospective cohort of consecutive patients aged more than one year from both genders, seeking routine care for febrile episodes at dispensaries located in the Bagamoyo district of Tanzania, were enrolled into the study after signing an informed consent form. Blood samples were taken for thick blood smear (TBS) microscopic examination and malaria RDT (SD Bioline Malaria Antigen Pf/PanTM (SD RDT)). RDT results were interpreted by both visual interpretation and DekiReaderTM device. Results of visual interpretation were used for case management purposes. Microscopy was considered the "gold standard test" to assess the sensitivity and specificity of the DekiReader interpretation and to compare it to visual interpretation. In total, 1,346 febrile subjects were included in the final analysis. The SD RDT, when used in conjunction with the DekiReader and upon visual interpretation, had sensitivities of 95.3% (95% CI, 90.6-97.7) and 94.7% (95% CI, 89.8--97.3) respectively, and specificities of 94.6% (95% CI, 93.5--96.1) and 95.6% (95% CI, 94.2--96.6), respectively to gold standard. There was a high percentage of overall agreement between the two methods of interpretation. The sensitivity and specificity of the DekiReader in interpretation of SD RDTs were comparable to previous reports and showed high agreement to visual interpretation (>98%). The results of the study reflect the situation in real practice and show good performance characteristics of DekiReader on interpreting malaria RDTs in the hands of local laboratory technicians. They also suggest that a system like this could provide great benefits to the health care system. Further studies to look at ease of use by community health workers, and cost benefit of the system are warranted

Prevalence of Malaria Parasitemia and Purchase of Artemisinin-Based Combination Therapies (ACTs) among Drug Shop Clients in Two Regions in Tanzania with ACT Subsidies.

Throughout Africa, many people seek care for malaria in private-sector drug shops where diagnostic testing is often unavailable. Recently, subsidized artemisinin-based combination therapies (ACTs), a first-line medication for uncomplicated malaria, were made available in these drug shops in Tanzania. This study assessed the prevalence of malaria among and purchase of ACTs by drug shop clients in the setting of a national ACT subsidy program and sub-national drug shop accreditation program. A cross-sectional survey of drug shop clients was performed in two regions in Tanzania, one with a government drug shop accreditation program and one without, from March-May, 2012. Drug shops were randomly sampled from non-urban districts. Shop attendants were interviewed about their education, training, and accreditation status. Clients were interviewed about their symptoms and medication purchases, then underwent a limited physical examination and laboratory testing for malaria. Malaria prevalence and predictors of ACT purchase were assessed using univariate analysis and multiple logistic regression. Amongst 777 clients from 73 drug shops, the prevalence of laboratory-confirmed malaria was 12% (95% CI: 6-18%). Less than a third of clients with malaria had purchased ACTs, and less than a quarter of clients who purchased ACTs tested positive for malaria. Clients were more likely to have purchased ACTs if the participant was <5 years old (aOR: 6.6; 95% CI: 3.9-11.0) or the shop attendant had >5 years, experience (aOR: 2.8; 95% CI: 1.2-6.3). Having malaria was only a predictor of ACT purchase in the region with a drug shop accreditation program (aOR: 3.4; 95% CI: 1.5-7.4).\ud Malaria is common amongst persons presenting to drug shops with a complaint of fever. The low proportion of persons with malaria purchasing ACTs, and the high proportion of ACTs going to persons without malaria demonstrates a need to better target who receives ACTs in these drug shops

Correct Dosing of Artemether-Lumefantrine for Management of Uncomplicated Malaria in Rural Tanzania: Do facility and Patient Characteristics Matter?

Use of artemisinin-based combination therapy (ACT), such as artemether-lumefantrine (AL), requires a strict dosing schedule that follows the drugs' pharmacokinetic properties. The quality of malaria case management was assessed in two areas in rural Tanzania, to ascertain patient characteristics and facility-specific factors that influence correct dosing of AL for management of uncomplicated malaria. Exit interviews were conducted with patients attending health facilities for initial illness consultation. Information about health workers' training and supervision visits was collected. Health facilities were inventoried for capacity and availability of medical products related to care of malaria patients. The outcome was correct dosing of AL based on age and weight. Logistic regression was used to assess health facility factors and patient characteristics associated with correct dosing of AL by age and weight. A total of 1,531 patients were interviewed, but 60 pregnant women were excluded from the analysis. Only 503 (34.2%) patients who received AL were assessed for correct dosing. Most patients who received AL (85.3%) were seen in public health facilities, 75.7% in a dispensary and 91.1% in a facility that had AL in stock on the survey day. Overall, 92.1% (463) of AL prescriptions were correct by age or weight; but 85.7% of patients received correct dosing by weight alone and 78.5% received correct dosing by age alone. In multivariate analysis, patients in the middle dosing bands in terms of age or weight, had statistically significant lower odds of correct AL dosing (p < 0.05) compared to those in the lowest age or weight group. Other factors such as health worker supervision and training on ACT did not improve the odds of correct AL dosing. Although malaria treatment guidelines indicate AL dosing can be prescribed based on age or weight of the patient, findings from this study show that patients within the middle age and weight dosing bands were least likely to receive a correct dose by either measure. Clinicians should be made aware of AL dosing errors for patients aged three to 12 years and advised to use weight-based prescriptions whenever possible