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Bhakti Hansoti, Alexander Jenson, Devin Keefe, Sarah Stewart De Ramirez, Trisha Anest, Michelle Twomey, Katie Lobner, Gabor Kelen, Lee Wallis
BACKGROUND: Despite the high burden of pediatric mortality from preventable conditions in low and middle income countries and the existence of multiple tools to prioritize critically ill children in low-resource settings, no analysis exists of the reliability and validity of these tools in identifying critically ill children in these scenarios. METHODS: The authors performed a systematic search of the peer-reviewed literature published, for studies pertaining to for triage and IMCI in low and middle-income countries in English language, from January 01, 2000 to October 22, 2013...
January 26, 2017: BMC Pediatrics
Fannah A Al-Araimi, Sitwat U Langrial
OBJECTIVES: This study aimed to test a hypothetical model to predict nursing students' perceptions of the usefulness of pre-service Integrated Management of Childhood Illness (IMCI) training and their intention to apply this training in clinical practice. METHODS: This study was carried out at the Sur Nursing Institute, Sur, Oman, in May 2015. Using six predefined constructs, a hypothetical structural model was created. The constructs were used as latent variables to highlight their probable impact on intention to apply IMCI-related knowledge and skills in practice...
November 2016: Sultan Qaboos University Medical Journal
Emily White Johansson
BACKGROUND: Malaria rapid diagnostic tests (RDTs) have great potential to improve quality care and rational drug use in malaria-endemic settings although studies have shown common RDT non-compliance. Yet, evidence has largely been derived from limited hospital settings in few countries. This article reviews a PhD thesis that analyzed national surveys from multiple sub-Saharan African countries to generate large-scale evidence of malaria diagnosis practices and its determinants across different contexts...
2016: Global Health Action
Kevin Mortimer, Chifundo B Ndamala, Andrew W Naunje, Jullita Malava, Cynthia Katundu, William Weston, Deborah Havens, Daniel Pope, Nigel G Bruce, Moffat Nyirenda, Duolao Wang, Amelia Crampin, Jonathan Grigg, John Balmes, Stephen B Gordon
BACKGROUND: WHO estimates exposure to air pollution from cooking with solid fuels is associated with over 4 million premature deaths worldwide every year including half a million children under the age of 5 years from pneumonia. We hypothesised that replacing open fires with cleaner burning biomass-fuelled cookstoves would reduce pneumonia incidence in young children. METHODS: We did a community-level open cluster randomised controlled trial to compare the effects of a cleaner burning biomass-fuelled cookstove intervention to continuation of open fire cooking on pneumonia in children living in two rural districts, Chikhwawa and Karonga, of Malawi...
January 14, 2017: Lancet
Ghulam Farooq Mansoor, Paata Chikvaidze, Sherin Varkey, Ariel Higgins-Steele, Najibullah Safi, Adela Mubasher, Khaksar Yusufi, Sayed Alisha Alawi
Objective: To assess quality of the national Integrated Management of Childhood Illness (IMCI) program services provided for sick children at primary health facilities in Afghanistan. Design: Mixed methods including cross-sectional study. Setting: Thirteen (of thirty-four) provinces in Afghanistan. Participants: Observation of case management and re-examination of 177 sick children, exit interviews with caretakers and review of equipment/supplies at 44 health facilities...
February 1, 2017: International Journal for Quality in Health Care
Amy Sarah Ginsburg, Charlotte Tawiah Agyemang, Gwen Ambler, Jaclyn Delarosa, Waylon Brunette, Shahar Levari, Clarice Larson, Mitch Sundt, Sam Newton, Gaetano Borriello, Richard Anderson
Pneumonia is the leading cause of infectious disease mortality in children. Currently, health care providers (HCPs) are trained to use World Health Organization Integrated Management of Childhood Illness (IMCI) paper-based protocols and manually assess respiratory rate to diagnose pneumonia in low-resource settings (LRS). However, this approach of relying on clinical signs alone has proven problematic. Hypoxemia, a diagnostic indicator of pneumonia severity associated with an increased risk of death, is not assessed because pulse oximetry is often not available in LRS...
2016: PloS One
R Solomons, M Grantham, B J Marais, R van Toorn
BACKGROUND: The diagnosis of tuberculous meningitis (TBM) in children is often delayed, with disastrous consequences. The Integrated Management of Childhood Illness (IMCI) strategy aims to ensure the accurate assessment of ill children using simple yet reliable clinical signs. METHODS: We conducted a retrospective observational study of 30 consecutive children aged 3 months to 5 years diagnosed with TBM at Tygerberg Hospital, Cape Town, South Africa. Clinical records were reviewed to assess diagnostic delay and identify IMCI indicators that were present at the time of initial presentation...
October 2016: International Journal of Tuberculosis and Lung Disease
Adam C Levine, Justin Glavis-Bloom, Payal Modi, Sabiha Nasrin, Bita Atika, Soham Rege, Sarah Robertson, Christopher H Schmid, Nur H Alam
BACKGROUND: Dehydration due to diarrhoea is a leading cause of child death worldwide, yet no clinical tools for assessing dehydration have been validated in resource-limited settings. The Dehydration: Assessing Kids Accurately (DHAKA) score was derived for assessing dehydration in children with diarrhoea in a low-income country setting. In this study, we aimed to externally validate the DHAKA score in a new population of children and compare its accuracy and reliability to the current Integrated Management of Childhood Illness (IMCI) algorithm...
October 2016: Lancet Global Health
Karl Blanchet, James J Lewis, Francisco Pozo-Martin, Arsene Satouro, Serge Somda, Patrick Ilboudo, Sophie Sarrassat, Simon Cousens
BACKGROUND: Burkina Faso introduced the Integrated Management of Childhood Illnesses (IMCI) strategy in 2003. However, an evaluation conducted in 2013 found that only 28 % of children were assessed for three danger signs as recommended by IMCI, and only 15 % of children were correctly classified. About 30 % of children were correctly prescribed with an antibiotic for suspected pneumonia or oral rehydration salts (ORS) for diarrhoea, and 40 % were correctly referred. Recent advances in information and communication technologies (ICT) and use of electronic clinical protocols hold the potential to transform healthcare delivery in low-income countries...
August 4, 2016: Implementation Science: IS
Anbrasi Edward, Kim Dam, Jane Chege, Annette E Ghee, Hossein Zare, Chea Chhorvann
OBJECTIVE: To assess the quality of care provided in rural pediatric facilities in Cambodia, Guatemala, Kenya and Zambia DESIGN: All public health facilities in four districts in each country were included in the assessment. Based on utilization patterns, five children under five were selected randomly from each facility to perform the Integrated Management of Childhood Illness (IMCI) assessments followed by exit interviews with their caretakers. SETTING: Seventy rural ambulatory pediatric care facilities...
October 2016: International Journal for Quality in Health Care
Emily White Johansson, Katarina Ekholm Selling, Humphreys Nsona, Bonnie Mappin, Peter W Gething, Max Petzold, Stefan Swartling Peterson, Helena Hildenwall
BACKGROUND: There are growing concerns about irrational antibiotic prescription practices in the era of test-based malaria case management. This study assessed integrated paediatric fever management using malaria rapid diagnostic tests (RDT) and Integrated Management of Childhood Illness (IMCI) guidelines, including the relationship between RDT-negative results and antibiotic over-treatment in Malawi health facilities in 2013-2014. METHODS: A Malawi national facility census included 1981 observed sick children aged 2-59 months with fever complaints...
2016: Malaria Journal
Tarun Gera, Dheeraj Shah, Paul Garner, Marty Richardson, Harshpal S Sachdev
BACKGROUND: More than 7.5 million children younger than age five living in low- and middle-income countries die every year. The World Health Organization (WHO) developed the integrated management of childhood illness (IMCI) strategy to reduce mortality and morbidity and to improve quality of care by improving the delivery of a variety of curative and preventive medical and behavioral interventions at health facilities, at home, and in the community. OBJECTIVES: To evaluate the effects of programs that implement the IMCI strategy in terms of death, nutritional status, quality of care, coverage with IMCI deliverables, and satisfaction of beneficiaries...
2016: Cochrane Database of Systematic Reviews
Moherndran Archary, Hugh Adler, Philip La Russa, Prasha Mahabeer, Raziya A Bobat
BACKGROUND: Bacterial infections in HIV-infected children admitted with severe acute malnutrition (SAM) contribute to higher mortality and poorer outcomes. This study describes the spectrum of bacterial infections in antiretroviral treatment (ART)-naïve, HIV-infected children admitted with SAM. METHODS: Between July 2012 and February 2015, 82 children were prospectively enrolled in the King Edward VIII Hospital, Durban. Specimens obtained on and during admission for microbiological evaluation, if clinically indicated, included blood, urine (obtained by catheterisation or suprapubic aspiration), induced sputum and cerebrospinal fluid...
February 2017: Paediatrics and International Child Health
Xavier Nsabagasani, Japer Ogwal-Okeng, Ebba Holme Hansen, Anthony Mbonye, Herbert Muyinda, Freddie Ssengooba
BACKGROUND: The Integrated Management of Childhood Illnesses is the main approach for treating children in more than 100 low income countries worldwide. In 2007, the World Health Assembly urged countries to integrate 'better medicines for children' into their essential medicines lists and treatment guidelines. WHO regularly provides generic algorithms for IMCI and publishes the Model Essential Medicines List with child-friendly medicines based on new evidence for member countries to adopt...
2016: Journal of Pharmaceutical Policy and Practice
Caroline Makokha, Joshua Mott, Henry N Njuguna, Sammy Khagayi, Jennifer R Verani, Bryan Nyawanda, Nancy Otieno, Mark A Katz
Although the severe acute respiratory illness (SARI) case definition is increasingly used for inpatient influenza surveillance, pneumonia is a more familiar term to clinicians and policymakers. We evaluated WHO case definitions for severe acute respiratory illness (SARI) and pneumonia (Integrated Management of Childhood Illnesses (IMCI) for children aged <5 years and Integrated Management of Adolescent and Adult Illnesses (IMAI) for patients aged ≥13 years) for detecting laboratory-confirmed influenza among hospitalized ARI patients...
July 2016: Influenza and Other Respiratory Viruses
Bryan O Nyawanda, Joshua A Mott, Henry N Njuguna, Lilian Mayieka, Sammy Khagayi, Reuben Onkoba, Caroline Makokha, Nancy A Otieno, Godfrey M Bigogo, Mark A Katz, Daniel R Feikin, Jennifer R Verani
BACKGROUND: In order to better understand respiratory syncytial virus (RSV) epidemiology and burden in tropical Africa, optimal case definitions for detection of RSV cases need to be identified. METHODS: We used data collected between September 2009 - August 2013 from children aged <5 years hospitalized with acute respiratory Illness at Siaya County Referral Hospital. We evaluated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of individual signs, symptoms and standard respiratory disease case definitions (severe acute respiratory illness [SARI]; hospitalized influenza-like illness [hILI]; integrated management of childhood illness [IMCI] pneumonia) to detect laboratory-confirmed RSV infection...
2016: BMC Infectious Diseases
Ngozi Kalu, Norman Lufesi, Deborah Havens, Kevin Mortimer
The Cooking and Pneumonia Study (CAPS) is a pragmatic cluster-level randomized controlled trial of the effect of an advanced cookstove intervention on pneumonia in children under the age of 5 years (under 5s) in Malawi ( The primary outcome of the trial is the incidence of pneumonia during a two-year follow-up period, as diagnosed by healthcare providers who are using the World Health Organization (WHO) integrated management of childhood illnesses (IMCI) pneumonia assessment protocol and who are blinded to the trial arms...
2016: PloS One
Salem A Sallam, Abdel-Azeem M El-Mazary, Ashraf M Osman, Mohamed A Bahaa
BACKGROUND: Fever is one of the most frequently encountered pediatric problems, accounting for 25% of visits to pediatric emergency room. There is no specific standardized approach to reach to a final diagnosis in children with fever as this may be difficult and individualized for each child. The integrated management of childhood illness (IMCI) approach is an approach designed to reach a classification rather than a specific diagnosis. OBJECTIVE: Comparison between IMCI and Non-IMCI approaches in management of children with high grade fever≥ 39°...
April 2016: International Journal of Health Sciences
Hubert Barennes, Eng Sayavong, Eric Pussard
INTRODUCTION: Hypoglycemia is a recognized feature of severe malaria but its diagnosis and management remain problematic in resource-limited settings. There is limited data on the burden and prognosis associated with glycemia dysregulation in non-neonate children in non-malaria areas. We prospectively assessed the abnormal blood glucose prevalence and the outcome and risk factors of deaths in critically ill children admitted to a national referral hospital in Laos. METHODS: Consecutive children (1 month-15 years) admitted to the pediatric ward of Mahosot hospital, were categorized using the integrated management of childhood illness (IMCI)...
2016: PloS One
Lucia U Mupara, Johanna C Lubbe
BACKGROUND: Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI) strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR) have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions...
2016: Global Health Action
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