Materials and methods: Multiple interviews and an entomological survey were conducted to elucidate the possible mechanism of infection in this patient.
Results: Findings point to locally-transmitted malaria, likely introduced by a patient from an endemic region in Tawau. Transmission via this route is rare, and has never before been reported in our setting.
Conclusions: This rare case highlights the need for constant vigilance in malaria control and elimination, especially when the target of country-wide elimination is close.
METHOD: This study is a retrospective review of 116 pediatric patients presenting with sore throat. Group A comprised patients before the implementation of the McIsaac rule and Group B comprised patients after the implementation.
RESULTS: Unnecessary throat swab cultures were reduced by 40% (P = 0.003). Redundant antibiotic prescriptions were reduced by 26.5% (P = 0.003) and the overall use of antibiotics was reduced by 22.1% (P = 0.003). The pediatricians' compliance rate to McIsaac rule criteria was 45% before implementation of the McIsaac rule, but improved to 67.9% (P = 0.0005) after implementation.
DISCUSSION: The McIsaac rule is an effective tool for the management of sore throat in children in Malaysia.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10668-021-01719-z.