Managing the Sick Child in the Era of Declining Malaria Transmission: Development of ALMANACH, an Electronic Algorithm for Appropriate Use of Antimicrobials.

Détails

Ressource 1Télécharger: BIB_2BE1064B9161.P001.pdf (2082.08 [Ko])
Etat: Serval
Version: de l'auteur
ID Serval
serval:BIB_2BE1064B9161
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Managing the Sick Child in the Era of Declining Malaria Transmission: Development of ALMANACH, an Electronic Algorithm for Appropriate Use of Antimicrobials.
Périodique
Plos One
Auteur(s)
Rambaud-Althaus C., Shao A.F., Kahama-Maro J., Genton B., d'Acremont V.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
10
Numéro
7
Pages
e0127674
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: epublish
Résumé
OBJECTIVE: To review the available knowledge on epidemiology and diagnoses of acute infections in children aged 2 to 59 months in primary care setting and develop an electronic algorithm for the Integrated Management of Childhood Illness to reach optimal clinical outcome and rational use of medicines.
METHODS: A structured literature review in Medline, Embase and the Cochrane Database of Systematic Review (CDRS) looked for available estimations of diseases prevalence in outpatients aged 2-59 months, and for available evidence on i) accuracy of clinical predictors, and ii) performance of point-of-care tests for targeted diseases. A new algorithm for the management of childhood illness (ALMANACH) was designed based on evidence retrieved and results of a study on etiologies of fever in Tanzanian children outpatients.
FINDINGS: The major changes in ALMANACH compared to IMCI (2008 version) are the following: i) assessment of 10 danger signs, ii) classification of non-severe children into febrile and non-febrile illness, the latter receiving no antibiotics, iii) classification of pneumonia based on a respiratory rate threshold of 50 assessed twice for febrile children 12-59 months; iv) malaria rapid diagnostic test performed for all febrile children. In the absence of identified source of fever at the end of the assessment, v) urine dipstick performed for febrile children <2 years to consider urinary tract infection, vi) classification of 'possible typhoid' for febrile children >2 years with abdominal tenderness; and lastly vii) classification of 'likely viral infection' in case of negative results.
CONCLUSION: This smartphone-run algorithm based on new evidence and two point-of-care tests should improve the quality of care of <5 year children and lead to more rational use of antimicrobials.
Mots-clé
Antimalarials/therapeutic use, Child, Child, Preschool, Diagnostic Tests, Routine/methods, Disease Management, Humans, Infant, Malaria/complications, Malaria/diagnosis, Plasmodium/drug effects, Plasmodium/isolation & purification, Point-of-Care Systems, Smartphone, Tanzania/epidemiology
Pubmed
Web of science
Open Access
Oui
Création de la notice
24/08/2015 17:42
Dernière modification de la notice
08/05/2019 16:22
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