Differences in diagnosis, management, and outcomes of acute febrile illness by health facility level in southern Ethiopia
Abstract We assessed the diagnosis, management and outcomes of acute febrile illness in a cohort of febrile children aged under 5 years presenting at one urban and two rural health centres and one tertiary hospital between 11 August 2019 and 01 November 2019. Pneumonia was diagnosed in 104 (30.8%) o...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-11-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-23641-8 |
| _version_ | 1798019183506620416 |
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| author | Techalew Shimelis Susana Vaz Nery Gill Schierhout Birkneh Tilahun Tadesse Sabine Dittrich John A. Crump John M. Kaldor |
| author_facet | Techalew Shimelis Susana Vaz Nery Gill Schierhout Birkneh Tilahun Tadesse Sabine Dittrich John A. Crump John M. Kaldor |
| author_sort | Techalew Shimelis |
| collection | DOAJ |
| description | Abstract We assessed the diagnosis, management and outcomes of acute febrile illness in a cohort of febrile children aged under 5 years presenting at one urban and two rural health centres and one tertiary hospital between 11 August 2019 and 01 November 2019. Pneumonia was diagnosed in 104 (30.8%) of 338 children at health centres and 128 (65.0%) of 197 at the hospital (p < 0.001). Malaria was detected in 33 (24.3%) of 136 children at the urban health centre, and in 55 (55.6%) of 99 and 7 (7.4%) of 95 children at the rural health centres compared to 11 (11.6%) of 95 at the hospital. Antibacterials were prescribed to 20 (11.5%) of 174 children without guidelines-specified indications (overprescribing) at health centres and in 7 (33.3%) of 21 children at the hospital (p = 0.013). Antimalarials were overprescribed to 13 (7.0%) of 185 children with negative malaria microscopy at the hospital. The fever resolved by day 7 in 326 (99.7%) of 327 children at health centres compared to 177 (93.2%) of 190 at the hospital (p < 0.001). These results suggest that additional guidance to health workers is needed to optimise the use of antimicrobials across all levels of health facilities. |
| first_indexed | 2024-04-11T16:36:27Z |
| format | Article |
| id | doaj.art-e8fef87f876344dcb36f07a6483fc750 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-11T16:36:27Z |
| publishDate | 2022-11-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-e8fef87f876344dcb36f07a6483fc7502022-12-22T04:13:50ZengNature PortfolioScientific Reports2045-23222022-11-011211910.1038/s41598-022-23641-8Differences in diagnosis, management, and outcomes of acute febrile illness by health facility level in southern EthiopiaTechalew Shimelis0Susana Vaz Nery1Gill Schierhout2Birkneh Tilahun Tadesse3Sabine Dittrich4John A. Crump5John M. Kaldor6Kirby Institute, University of New South WalesKirby Institute, University of New South WalesThe George Institute for Global Health, University of New South WalesCollege of Medicine and Health Sciences, Hawassa UniversityFoundation for Innovative New DiagnosticsCentre for International Health, University of OtagoKirby Institute, University of New South WalesAbstract We assessed the diagnosis, management and outcomes of acute febrile illness in a cohort of febrile children aged under 5 years presenting at one urban and two rural health centres and one tertiary hospital between 11 August 2019 and 01 November 2019. Pneumonia was diagnosed in 104 (30.8%) of 338 children at health centres and 128 (65.0%) of 197 at the hospital (p < 0.001). Malaria was detected in 33 (24.3%) of 136 children at the urban health centre, and in 55 (55.6%) of 99 and 7 (7.4%) of 95 children at the rural health centres compared to 11 (11.6%) of 95 at the hospital. Antibacterials were prescribed to 20 (11.5%) of 174 children without guidelines-specified indications (overprescribing) at health centres and in 7 (33.3%) of 21 children at the hospital (p = 0.013). Antimalarials were overprescribed to 13 (7.0%) of 185 children with negative malaria microscopy at the hospital. The fever resolved by day 7 in 326 (99.7%) of 327 children at health centres compared to 177 (93.2%) of 190 at the hospital (p < 0.001). These results suggest that additional guidance to health workers is needed to optimise the use of antimicrobials across all levels of health facilities.https://doi.org/10.1038/s41598-022-23641-8 |
| spellingShingle | Techalew Shimelis Susana Vaz Nery Gill Schierhout Birkneh Tilahun Tadesse Sabine Dittrich John A. Crump John M. Kaldor Differences in diagnosis, management, and outcomes of acute febrile illness by health facility level in southern Ethiopia Scientific Reports |
| title | Differences in diagnosis, management, and outcomes of acute febrile illness by health facility level in southern Ethiopia |
| title_full | Differences in diagnosis, management, and outcomes of acute febrile illness by health facility level in southern Ethiopia |
| title_fullStr | Differences in diagnosis, management, and outcomes of acute febrile illness by health facility level in southern Ethiopia |
| title_full_unstemmed | Differences in diagnosis, management, and outcomes of acute febrile illness by health facility level in southern Ethiopia |
| title_short | Differences in diagnosis, management, and outcomes of acute febrile illness by health facility level in southern Ethiopia |
| title_sort | differences in diagnosis management and outcomes of acute febrile illness by health facility level in southern ethiopia |
| url | https://doi.org/10.1038/s41598-022-23641-8 |
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