Under treatment of pneumonia among children under 5 years of age in a malaria-endemic area: population-based surveillance study conducted in Manhica district- rural, Mozambique
Background: Integrated Management of Childhood Illness (IMCI) guidelines were developed to decrease morbidity and mortality, yet implementation varies across settings. Factors associated with poor adherence are not well understood. Methods: We used data from Manhiça District Hospital outpatient depa...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2015-07-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971215001186 |
| _version_ | 1818288937511157760 |
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| author | Sozinho Acácio Jennifer R. Verani Miguel Lanaspa Tarayn A. Fairlie Tacilta Nhampossa Maria Ruperez Pedro Aide Brian D. Plikaytis Charfudin Sacoor Eusebio Macete Pedro Alonso Betuel Sigaúque |
| author_facet | Sozinho Acácio Jennifer R. Verani Miguel Lanaspa Tarayn A. Fairlie Tacilta Nhampossa Maria Ruperez Pedro Aide Brian D. Plikaytis Charfudin Sacoor Eusebio Macete Pedro Alonso Betuel Sigaúque |
| author_sort | Sozinho Acácio |
| collection | DOAJ |
| description | Background: Integrated Management of Childhood Illness (IMCI) guidelines were developed to decrease morbidity and mortality, yet implementation varies across settings. Factors associated with poor adherence are not well understood.
Methods: We used data from Manhiça District Hospital outpatient department and five peripheral health centers to examine pneumonia management for children <5 years old from January 2008 to June 2011. Episodes of IMCI-defined pneumonia (cough or difficult breathing plus tachypnea), severe pneumonia (pneumonia plus chest wall in-drawing), and/or clinician-diagnosed pneumonia (based on discharge diagnosis) were included.
Results: Among severe pneumonia episodes, 96.2% (2,918/3,032) attended in the outpatient department and 70.0% (291/416) attended in health centers were appropriately referred to the emergency department. Age<1 year, malnutrition and various physical exam findings were associated with referral. For non-severe pneumonia episodes, antibiotics were prescribed in 45.7% (16,094/35,224). Factors associated with antibiotic prescription included age <1 year, abnormal auscultatory findings, and clinical diagnosis of pneumonia; diagnosis of malaria or gastroenteritis and pallor were negatively associated with antibiotic prescription.
Conclusion: Adherence to recommended management of severe pneumonia was high in a hospital outpatient department, but suboptimal in health centers. Antibiotics were prescribed in fewer than half of non-severe pneumonia episodes, and diagnosis of malaria was the strongest risk factor for incorrect management. |
| first_indexed | 2024-12-13T02:04:19Z |
| format | Article |
| id | doaj.art-6258c0086f284426af81c9fb8a6dc755 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 1878-3511 |
| language | English |
| last_indexed | 2024-12-13T02:04:19Z |
| publishDate | 2015-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-6258c0086f284426af81c9fb8a6dc7552022-12-22T00:03:10ZengElsevierInternational Journal of Infectious Diseases1201-97121878-35112015-07-0136C394510.1016/j.ijid.2015.05.010Under treatment of pneumonia among children under 5 years of age in a malaria-endemic area: population-based surveillance study conducted in Manhica district- rural, MozambiqueSozinho Acácio0Jennifer R. Verani1Miguel Lanaspa2Tarayn A. Fairlie3Tacilta Nhampossa4Maria Ruperez5Pedro Aide6Brian D. Plikaytis7Charfudin Sacoor8Eusebio Macete9Pedro Alonso10Betuel Sigaúque11Centro de Investigação em Saúde de Manhiça – Road 12. Manhiça, MozambiqueCenters for Disease Control and Prevention - 1600 Clifton Road, Atlanta, GA 30329 USACentro de Investigação em Saúde de Manhiça – Road 12. Manhiça, MozambiqueCenters for Disease Control and Prevention - 1600 Clifton Road, Atlanta, GA 30329 USACentro de Investigação em Saúde de Manhiça – Road 12. Manhiça, MozambiqueCentro de Investigação em Saúde de Manhiça – Road 12. Manhiça, MozambiqueCentro de Investigação em Saúde de Manhiça – Road 12. Manhiça, MozambiqueCenters for Disease Control and Prevention - 1600 Clifton Road, Atlanta, GA 30329 USACentro de Investigação em Saúde de Manhiça – Road 12. Manhiça, MozambiqueCentro de Investigação em Saúde de Manhiça – Road 12. Manhiça, MozambiqueCentro de Investigação em Saúde de Manhiça – Road 12. Manhiça, MozambiqueCentro de Investigação em Saúde de Manhiça – Road 12. Manhiça, MozambiqueBackground: Integrated Management of Childhood Illness (IMCI) guidelines were developed to decrease morbidity and mortality, yet implementation varies across settings. Factors associated with poor adherence are not well understood. Methods: We used data from Manhiça District Hospital outpatient department and five peripheral health centers to examine pneumonia management for children <5 years old from January 2008 to June 2011. Episodes of IMCI-defined pneumonia (cough or difficult breathing plus tachypnea), severe pneumonia (pneumonia plus chest wall in-drawing), and/or clinician-diagnosed pneumonia (based on discharge diagnosis) were included. Results: Among severe pneumonia episodes, 96.2% (2,918/3,032) attended in the outpatient department and 70.0% (291/416) attended in health centers were appropriately referred to the emergency department. Age<1 year, malnutrition and various physical exam findings were associated with referral. For non-severe pneumonia episodes, antibiotics were prescribed in 45.7% (16,094/35,224). Factors associated with antibiotic prescription included age <1 year, abnormal auscultatory findings, and clinical diagnosis of pneumonia; diagnosis of malaria or gastroenteritis and pallor were negatively associated with antibiotic prescription. Conclusion: Adherence to recommended management of severe pneumonia was high in a hospital outpatient department, but suboptimal in health centers. Antibiotics were prescribed in fewer than half of non-severe pneumonia episodes, and diagnosis of malaria was the strongest risk factor for incorrect management.http://www.sciencedirect.com/science/article/pii/S1201971215001186PneumoniaMozambiqueGuideline Adherence |
| spellingShingle | Sozinho Acácio Jennifer R. Verani Miguel Lanaspa Tarayn A. Fairlie Tacilta Nhampossa Maria Ruperez Pedro Aide Brian D. Plikaytis Charfudin Sacoor Eusebio Macete Pedro Alonso Betuel Sigaúque Under treatment of pneumonia among children under 5 years of age in a malaria-endemic area: population-based surveillance study conducted in Manhica district- rural, Mozambique International Journal of Infectious Diseases Pneumonia Mozambique Guideline Adherence |
| title | Under treatment of pneumonia among children under 5 years of age in a malaria-endemic area: population-based surveillance study conducted in Manhica district- rural, Mozambique |
| title_full | Under treatment of pneumonia among children under 5 years of age in a malaria-endemic area: population-based surveillance study conducted in Manhica district- rural, Mozambique |
| title_fullStr | Under treatment of pneumonia among children under 5 years of age in a malaria-endemic area: population-based surveillance study conducted in Manhica district- rural, Mozambique |
| title_full_unstemmed | Under treatment of pneumonia among children under 5 years of age in a malaria-endemic area: population-based surveillance study conducted in Manhica district- rural, Mozambique |
| title_short | Under treatment of pneumonia among children under 5 years of age in a malaria-endemic area: population-based surveillance study conducted in Manhica district- rural, Mozambique |
| title_sort | under treatment of pneumonia among children under 5 years of age in a malaria endemic area population based surveillance study conducted in manhica district rural mozambique |
| topic | Pneumonia Mozambique Guideline Adherence |
| url | http://www.sciencedirect.com/science/article/pii/S1201971215001186 |
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