Table 1 List of severe and non-severe signs and symptoms that community health workers (CHW) were trained to identify and refer in children

Refer using emergency referral form if child shows any of the following symptoms:

Refer using ordinary referral form if child shows any of the following symptoms:

 1. Illness in child below 2 months

 2. Convulsions of fits now or within the past 2 days

 3. Coma/loss of consciousness

 4. Patient is confused or very sleepy-cannot be woken

 5. Extreme weakness-unable to stand or sit without support

 6. Very Hot-with temperature of 38.5 °C or more

 7. Very Cold-with temperature of 35.0 °C of less

 8. Vomiting everything-cannot keep down food or drink

 9. Not able to drink of breast feed

 10. Severe anaemia-very pale palms, fingernails, eyelids

 11. Yellow eyes

 12. Difficulty in breathing

 13. Severe dehydration

1. Fever in babies less than 4 months old

2. Fever that has last for more than 7 days

3. Fever with measured temperatures of 37 °C or more and mRDT negative

4. Vomiting and diarrhea

5. Blood in faeces or blood in urine

6. Pain when passing urine or frequent urination

7. Wound or burns

8. Skin abscess

9. Painful swelling or lumps in the skin

10. Ear infection (runny ear or child pulling at the ear)

11. Sticky or red eyes

If RDT result is positive:

Treat child (if older than 2 months) with rectal artesunate suppository prior to referral.

If RDT results is positive:

Treat child (if older than 4 months) with artemether-lumefantine tablets prior to referral.