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https://www.readbyqxmd.com/read/29684634/interactive-electronic-decision-trees-for-the-integrated-primary-care-management-of-febrile-children-in-low-resource-settings-review-of-existing-tools
#1
REVIEW
Kristina Keitel, Valérie D'Acremont
BACKGROUND: The lack of effective, integrated diagnostic tools pose a major challenge to the primary care management of febrile childhood illnesses. These limitations are especially evident in low-resource settings and are often inappropriately compensated by antimicrobial over-prescription. Interactive electronic decision trees (IEDTs) have the potential to close these gaps: guiding antibiotic use and better identifying serious disease. AIMS: This narrative review summarizes existing IEDTs, to provide an overview of their degree of validation, as well as to identify gaps in current knowledge and prospects for future innovation...
April 20, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29662688/distribution-and-determinants-of-pneumonia-diagnosis-using-integrated-management-of-childhood-illness-guidelines-a-nationally-representative-study-in-malawi
#2
Omolara T Uwemedimo, Todd P Lewis, Elsie A Essien, Grace J Chan, Humphreys Nsona, Margaret E Kruk, Hannah H Leslie
Background: Pneumonia remains the leading cause of child mortality in sub-Saharan Africa. The Integrated Management of Childhood Illness (IMCI) strategy was developed to standardise care in low-income and middle-income countries for major childhood illnesses and can effectively improve healthcare worker performance. Suboptimal clinical evaluation can result in missed diagnoses and excess morbidity and mortality. We estimate the sensitivity of pneumonia diagnosis and investigate its determinants among children in Malawi...
2018: BMJ Global Health
https://www.readbyqxmd.com/read/29580278/a-mobile-phone-based-tool-to-identify-symptoms-of-common-childhood-diseases-in-ghana-development-and-evaluation-of-the-integrated-clinical-algorithm-in-a-cross-sectional-study
#3
Konstantin H Franke, Ralf Krumkamp, Aliyu Mohammed, Nimako Sarpong, Ellis Owusu-Dabo, Johanna Brinkel, Julius N Fobil, Axel Bonacic Marinovic, Philip Asihene, Mark Boots, Jürgen May, Benno Kreuels
BACKGROUND: The aim of this study was the development and evaluation of an algorithm-based diagnosis-tool, applicable on mobile phones, to support guardians in providing appropriate care to sick children. METHODS: The algorithm was developed on the basis of the Integrated Management of Childhood Illness (IMCI) guidelines and evaluated at a hospital in Ghana. Two hundred and thirty-seven guardians applied the tool to assess their child's symptoms. Data recorded by the tool and health records completed by a physician were compared in terms of symptom detection, disease assessment and treatment recommendation...
March 27, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29547624/economic-evaluation-of-a-mentorship-and-enhanced-supervision-program-to-improve-quality-of-integrated-management-of-childhood-illness-care-in-rural-rwanda
#4
Anatole Manzi, Jean Claude Mugunga, Hari S Iyer, Hema Magge, Fulgence Nkikabahizi, Lisa R Hirschhorn
BACKGROUND: Integrated management of childhood illness (IMCI) can reduce under-5 morbidity and mortality in low-income settings. A program to strengthen IMCI practices through Mentorship and Enhanced Supervision at Health centers (MESH) was implemented in two rural districts in eastern Rwanda in 2010. METHODS: We estimated cost per improvement in quality of care as measured by the difference in correct diagnosis and correct treatment at baseline and 12 months of MESH...
2018: PloS One
https://www.readbyqxmd.com/read/29523194/incidence-and-risk-factors-of-neonatal-infections-in-a-rural-bangladeshi-population-a-community-based-prospective-study
#5
Dipak K Mitra, Luke C Mullany, Meagan Harrison, Ishtiaq Mannan, Rashed Shah, Nazma Begum, Mamun Ibne Moin, Shams El Arifeen, Abdullah H Baqui
BACKGROUND: Infections cause about one fifth of the estimated 2.7 million annual neonatal deaths worldwide. Population-based data on burden and risk factors of neonatal infections are lacking in developing countries, which are required for the appropriate design of effective preventive and therapeutic interventions in resource-poor settings. METHODS: We used data from a community-based cluster-randomized trial conducted to evaluate the impact of two umbilical cord cleansing regimens with chlorhexidine solution on neonatal mortality and morbidity in a rural area of Sylhet District in Bangladesh...
March 9, 2018: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/29506083/addition-of-questions-on-parental-factors-to-the-who-integrated-management-of-childhood-illnesses-imci-hiv-algorithm-improves-the-utility-of-the-algorithm-for-diagnosis-of-hiv-infection-in-children
#6
Jagdish Chandra, Puneet Kaur Sahi, Sourabh Gupta, Rohini Ajay Gupta, Renu Dutta, B L Sherwal, Anju Seth, Praveen Kumar, Varinder Singh
The WHO Integrated Management of Childhood Illnesses-HIV (IMCI-HIV) algorithm and its regional adaptation have shown variable performance in clinically identifying HIV-infected children with lack of validation in low prevalence areas. Addition of certain 'parental factors' (proxy indicators of parental HIV) may improve its utility. In this study, children aged 2 months to 5 years were enrolled into Group A (n = 1000, 'suspected symptomatic HIV infected' children as per the IMNCI-HIV algorithm) and group B (n = 50, children newly diagnosed with HIV infection)...
February 28, 2018: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29457209/agreement-between-integrated-management-of-childhood-illness-and-final-diagnosis-in-acute-respiratory-tract-infections
#7
Sıddika Songül Yalçın, Beril Özdemir, Sadriye Özdemir, Esra Baskın
OBJECTIVE: To evaluate the agreement between integrated management of childhood illness (IMCI) and final diagnosis in patients presenting with cough at the second and third level health institutions. METHODS: This cross-sectional study included 373 children aged 2-60 mo who presented with cough at the pediatric emergency and outpatient clinics in the Department of Pediatrics. After clinical examination of children, body temperature, respiratory rate, saturation, presence or absence of the chest indrawing, rales, wheezing and laryngeal stridor were recorded...
February 19, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29443825/maternal-influenza-immunization-and-prevention-of-severe-clinical-pneumonia-in-young-infants-analysis-of-randomized-controlled-trials-conducted-in-nepal-mali-and-south-africa
#8
Saad B Omer, Dayna R Clark, Anushka R Aqil, Milagritos D Tapia, Marta C Nunes, Naoko Kozuki, Mark C Steinhoff, Shabir A Madhi, Niteen Wairagkar
BACKGROUND: To evaluate the effect of antenatal influenza vaccination on all-cause severe infant pneumonia, we performed pooled analysis of 3 randomized controlled trials conducted in Nepal, Mali and South Africa. METHODS: The trials were coordinated from the planning phase. The follow-up period was 0-6 months postpartum in Nepal and Mali and 0-24 weeks in South Africa. Pregnant women with gestational age 17-34 weeks in Nepal, ≥28 weeks in Mali and 20-36 weeks in South Africa were enrolled...
May 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29443325/a-survey-on-integrated-management-of-neonatal-and-childhood-illness-implementation-by-nurses-in-four-districts-of-west-arsi-zone-of-ethiopia
#9
Sheka Shemsi Seid, Endalew Gemechu Sendo
Background: In Ethiopia, one in 17 children dies before 1 year of age and one in 11 children dies before 5 years. Research that examines the factors influencing the implementation of the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) strategy in Ethiopia is limited. This study aimed to identify the factors compelling the execution of IMNCI by nurses in four districts of West Arsi zone of Ethiopia. Methods: A mixed-method cross-sectional study was conducted from February to March 2016 in West Arsi zone of Oromia regional state, Ethiopia...
2018: Pediatric Health, Medicine and Therapeutics
https://www.readbyqxmd.com/read/29330009/the-almanach-project-preliminary-results-and-potentiality-from-afghanistan
#10
A Bernasconi, F Crabbé, R Rossi, I Qani, A Vanobberghen, M Raab, S Du Mortier
INTRODUCTION: ALMANACH (ALgorithms for the MANagement of Acute CHildhood illnesses) is an electronic version of IMCI (Integrated Management of Childhood Illness) running on tablets. ALMANACH enhances its concept, it integrates well into health staff's daily consultation work and facilitates diagnosis and treatment. ALMANACH informs when to refer a child or to perform a rapid diagnostic test (RDT), recommends the right treatment dosage and synchronizes collected data real time with a Health Management Information System (DHIS2) for epidemiological evaluation and decision making...
December 28, 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29261649/cost-effectiveness-analysis-of-diarrhoea-management-approaches-in-nigeria-a-decision-analytical-model
#11
Charles E Okafor, Obinna I Ekwunife
BACKGROUND: Diarrhoea is a leading cause of death in Nigerian children under 5 years. Implementing the most cost-effective approach to diarrhoea management in Nigeria will help optimize health care resources allocation. This study evaluated the cost-effectiveness of various approaches to diarrhoea management namely: the 'no treatment' approach (NT); the preventive approach with rotavirus vaccine; the integrated management of childhood illness for diarrhoea approach (IMCI); and rotavirus vaccine plus integrated management of childhood illness for diarrhoea approach (rotavirus vaccine + IMCI)...
December 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29237494/adherence-to-the-integrated-management-of-childhood-illness-guidelines-in-namibia-kenya-tanzania-and-uganda-evidence-from-the-national-service-provision-assessment-surveys
#12
Carsten Krüger, Monika Heinzel-Gutenbrunner, Mohammed Ali
BACKGROUND: Integrated Management of Childhood Illness (IMCI) is regarded as a standard public health approach to lowering child mortality in developing countries. However, little is known about how health workers adhere to the guidelines at the national level in sub-Saharan African countries. METHODS: Data from the Service Provision Assessment surveys of Namibia (NA) (survey year: 2009), Kenya (KE) (2010), Tanzania (TZ) (2006) and Uganda (UG) (2007) were analysed for adherence to the IMCI guidelines by health workers...
December 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29233111/effectiveness-of-two-community-based-strategies-on-disease-knowledge-and-health-behaviour-regarding-malaria-diarrhoea-and-pneumonia-in-ghana
#13
Blanca Escribano-Ferrer, Margaret Gyapong, Jane Bruce, Solomon A Narh Bana, Clement T Narh, Naa-Korkor Allotey, Roland Glover, Charity Azantilow, Constance Bart-Plange, Isabella Sagoe-Moses, Jayne Webster
BACKGROUND: Ghana has developed two community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and suspected pneumonia, and to improve household and family practices: integrated Community Case Management (iCCM) and Community-based Health Planning and Services (CHPS). The objective of the study was to assess the effectiveness of iCCM and CHPS on disease knowledge and health behaviour regarding malaria, diarrhoea and pneumonia. METHODS: A household survey was conducted two and eight years after implementation of iCCM in the Volta and Northern Regions of Ghana respectively, and more than ten years of CHPS implementation in both regions...
December 12, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29221530/parenting-practices-and-associations-with-development-delays-among-young-children-in-dominican-republic
#14
Omolara Thomas Uwemedimo, Afrin Howlader, Giselina Pierret
BACKGROUND: According to the World Health Organization, >200 million children in low- and middle-income countries experience developmental delays. However, household structure and parenting practices have been minimally explored as potential correlates of developmental delay in low- and middle-income countries, despite potential as areas for intervention. OBJECTIVE: The objective of the study was to examine associations of developmental delays with use of World Health Organization-recommended parenting practices among a clinic-based cohort of children aged 6-60 months attending in La Romana, Dominican Republic...
May 2017: Annals of Global Health
https://www.readbyqxmd.com/read/29163934/determinants-of-integrated-management-of-childhood-illness-imci-non-severe-pneumonia-classification-and-care-in-malawi-health-facilities-analysis-of-a-national-facility-census
#15
Emily White Johansson, Humphreys Nsona, Liliana Carvajal-Aguirre, Agbessi Amouzou, Helena Hildenwall
Background: Research shows inadequate Integrated Management of Childhood Illness (IMCI)-pneumonia care in various low-income settings but evidence is largely from small-scale studies with limited evidence of patient-, provider- and facility-levels determinants of IMCI non-severe pneumonia classification and its management. Methods: The Malawi Service Provision Assessment 2013-2014 included 3149 outpatients aged 2-59 months with completed observations, interviews and re-examinations...
December 2017: Journal of Global Health
https://www.readbyqxmd.com/read/29161375/health-system-factors-affecting-implementation-of-integrated-management-of-childhood-illness-imci-qualitative-insights-from-a-south-african-province
#16
Himani Pandya, Wiedaad Slemming, Haroon Saloojee
The Integrated Management of Childhood Illness (IMCI) strategy has been adopted by 102 countries including South Africa, as the preferred primary health care (PHC) delivery strategy for sick children under 5 years. Despite substantial investment to support IMCI in South Africa, its delivery remains sub-optimal, with varied implementation in different settings. There is scarce research globally, and in the local context, examining the effects of health system characteristics on IMCI implementation. This study explored key determinants of IMCI delivery in a South African province, with a specific focus on health system building blocks using a health system dynamics framework...
March 1, 2018: Health Policy and Planning
https://www.readbyqxmd.com/read/29075300/adherence-to-integrated-management-of-childhood-illnesses-guideline-in-treating-south-sudanese-children-with-cough-or-difficulty-in-breathing
#17
Jonathan Izudi, Stanley Anyigu, David Ndungutse
BACKGROUND: Pneumonia substantially kills children aged 2-59 months in South Sudan. However, information on health workers adherence to Integrated Management of Childhood Illnesses (IMCI) guideline in treating children with cough/difficulty in breathing remains scarce. This study assessed factors associated with adherence to IMCI guideline in Aweil East County, South Sudan. METHODS: This cross-sectional study involved 232 health workers from 36 health facilities...
2017: International Journal of Pediatrics
https://www.readbyqxmd.com/read/29059253/a-novel-electronic-algorithm-using-host-biomarker-point-of-care-tests-for-the-management-of-febrile-illnesses-in-tanzanian-children-e-poct-a-randomized-controlled-non-inferiority-trial
#18
RANDOMIZED CONTROLLED TRIAL
Kristina Keitel, Frank Kagoro, Josephine Samaka, John Masimba, Zamzam Said, Hosiana Temba, Tarsis Mlaganile, Willy Sangu, Clotilde Rambaud-Althaus, Alain Gervaix, Blaise Genton, Valérie D'Acremont
BACKGROUND: The management of childhood infections remains inadequate in resource-limited countries, resulting in high mortality and irrational use of antimicrobials. Current disease management tools, such as the Integrated Management of Childhood Illness (IMCI) algorithm, rely solely on clinical signs and have not made use of available point-of-care tests (POCTs) that can help to identify children with severe infections and children in need of antibiotic treatment. e-POCT is a novel electronic algorithm based on current evidence; it guides clinicians through the entire consultation and recommends treatment based on a few clinical signs and POCT results, some performed in all patients (malaria rapid diagnostic test, hemoglobin, oximeter) and others in selected subgroups only (C-reactive protein, procalcitonin, glucometer)...
October 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28992150/are-children-presenting-with-non-imci-complaints-at-greater-risk-for-suboptimal-screening-an-analysis-of-outpatient-visits-in-afghanistan
#19
Maya Venkataramani, Anbrasi Edward, Paul Ickx, Motawali Younusi, Syed Ali Shah Alawi, David H Peters
Objective: To determine if children presenting without complaints related to the Integrated Management of Childhood Illness (IMCI) are at greater risk for suboptimal screening for IMCI conditions. Design: Cross-sectional study. Setting: Thirty-three provinces in Afghanistan. Participants: Observation of 3072 sick child visits selected by systematic random sampling. Main outcome measure(s): A 10 point IMCI assessment index...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28584603/a-hypothetical-model-to-predict-the-potential-impact-of-government-and-management-support-in-implementing-integrated-management-of-childhood-illness-practices
#20
Fannah Al Fannah Al Araimi
OBJECTIVES: Despite broad adoption and implementation of Integrated Management of Childhood Illness (IMCI) in more than 100 countries, childhood mortality and morbidity rates continue to prevail. This calls for further investigation to identify the factors that prevent actual application of IMCI-recommended clinical practices. This study tests a hypothetical structural model to investigate potential role of government and healthcare policymakers on improving implementation and application of IMCI-recommended practices in clinical setting...
May 2017: Oman Medical Journal
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