Safety of a new algorithm for the management of childhood illness (Almanach) to improve quality of care and rational use of drugs

Détails

ID Serval
serval:BIB_F19AD4EB52EA
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Titre
Safety of a new algorithm for the management of childhood illness (Almanach) to improve quality of care and rational use of drugs
Titre de la conférence
7th European Congress on Tropical Medicine and International Health
Auteur(s)
Shao A., Rambaud-Althaus C., Perri S., Swai N., Kahama-Maro J., Mitchell M., Genton B., D'Acremont V.
Adresse
Barcelona, Spain, October 3-6, 2011
ISBN
1360-2276
Statut éditorial
Publié
Date de publication
2011
Peer-reviewed
Oui
Volume
16
Série
Tropical Medicine and International Health
Pages
60
Langue
anglais
Notes
Publication type : Meeting Abstract
Résumé
Introduction New evidence from randomized controlled and etiology of fever studies, the availability of reliable RDT for malaria, and novel technologies call for revision of the IMCI strategy. We developed a new algorithm based on (i) a systematic review of published studies assessing the safety and appropriateness of RDT and antibiotic prescription, (ii) results from a clinical and microbiological investigation of febrile children aged <5 years, (iii) international expert IMCI opinions. The aim of this study was to assess the safety of the new algorithm among patients in urban and rural areas of Tanzania.Materials and Methods The design was a controlled noninferiority study. Enrolled children aged 2-59 months with any illness were managed either by a study clinician using the new Almanach algorithm (two intervention health facilities), or clinicians using standard practice, including RDT (two control HF). At day 7 and day 14, all patients were reassessed. Patients who were ill in between or not cured at day 14 were followed until recovery or death. Primary outcome was rate of complications, secondary outcome rate of antibiotic prescriptions.Results 1062 children were recruited. Main diagnoses were URTI 26%, pneumonia 19% and gastroenteritis (9.4%). 98% (531/541) were cured at D14 in the Almanach arm and 99.6% (519/521) in controls. Rate of secondary hospitalization was 0.2% in each. One death occurred in controls. None of the complications was due to withdrawal of antibiotics or antimalarials at day 0. Rate of antibiotic use was 19% in the Almanach arm and 84% in controls.Conclusion Evidence suggests that the new algorithm, primarily aimed at the rational use of drugs, is as safe as standard practice and leads to a drastic reduction of antibiotic use. The Almanach is currently being tested for clinician adherence to proposed procedures when used on paper or a mobile phone
Mots-clé
,
Web of science
Création de la notice
10/11/2011 10:32
Dernière modification de la notice
03/03/2018 22:38
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