A complex intervention to improve implementation of World Health Organization guidelines for diagnosis of severe illness in low-income settings: a quasi-experimental study from Uganda

Table 4 Impact of SIMS intervention on diagnosis of severe illness conditions (adjusted for site)

Severe illness condition % (95% CI)	Pre-intervention period n = 1633	Intervention period n = 4126	Risk ratio	P value
Sepsis	0.4 (0.0 to 0.9)	4.3 (4.2–4.5)	10.1 (3.3–30.7)	0.001
Severe respiratory distress	0.9 (0.1–1.6)	3.9 (3.7–4.1)	4.5 (1.8–10.9)	0.001
Shock	10.8 (6.4–15.2)	16.7 (15.1–18.2)	1.5 (0.9–2.5)	0.09
Altered mental status^a	5.2 (4.7–5.7)	3.5 (3.3–3.7)	0.7 (0.6–0.8)	<0.001

Abbreviations: CI confidence interval, SIMS Severe Illness Management System
^aAltered mental status defined as anything less than alert on the AVPU scale (alert (A), responsive to verbal stimuli (V), responsive to painful stimuli (P), and unresponsive (U))

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