Primary Care Case Management of Febrile Children: Insights From the ePOCT Routine Care Cohort in Dar es Salaam, Tanzania.
Détails
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_D99056D20494
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Primary Care Case Management of Febrile Children: Insights From the ePOCT Routine Care Cohort in Dar es Salaam, Tanzania.
Périodique
Frontiers in pediatrics
ISSN
2296-2360 (Print)
ISSN-L
2296-2360
Statut éditorial
Publié
Date de publication
2021
Peer-reviewed
Oui
Volume
9
Pages
626386
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Résumé
Aim: To provide insight in the primary health care (PHC) case management of febrile children under-five in Dar es Salaam, and to identify areas for improving quality of care. Methods: We used data from the routine care arm of the ePOCT trial, including children aged 2-59 months who presented with an acute febrile illness to two health centers in Dar es Salaam (2014-2016). The presenting complaint, anthropometrics, vital signs, test results, final diagnosis, and treatment were prospectively collected in all children. We used descriptive statistics to analyze the frequencies of diagnoses, adherence to diagnostics, and prescribed treatments. Results: We included 547 children (47% male, median age 14 months). Most diagnoses were viral: upper respiratory tract infection (60%) and/or gastro-enteritis (18%). Vital signs and anthropometric measurements taken by research staff and urinary testing failed to influence treatment decisions. In total, 518/547 (95%) children received antibiotics, while 119/547 (22%) had an indication for antibiotics based on local guidelines. Antibiotic dosing was frequently out of range. Non-recommended treatments were common (29%), most often cough syrup and vitamins. Conclusion: Our study points to challenges in using diagnostic test results, concerns regarding quality of antibiotic prescriptions, and frequent use of non-evidence-based complementary medicines in PHC in Tanzania. Larger studies on diagnostic and treatments processes in PHC in Tanzania are needed to inform effective solutions to support PHC workers in case management of children.
Mots-clé
decision-support, fever, infectious diseases, low-resource setting, pediatrics, primary care, quality of care
Pubmed
Web of science
Open Access
Oui
Création de la notice
22/06/2021 11:53
Dernière modification de la notice
23/11/2022 8:15