Clinical predictors of malaria and other febrile illnesses in children under five on Pemba Island, Tanzania

2005 ◽  
Vol 35 (2) ◽  
pp. 78-81 ◽  
Author(s):  
Sophie Yacoub ◽  
Mohammed Juma Mohammed ◽  
Mahdi Ramsan ◽  
Marco Albonico
Keyword(s):  
Severe Malaria ◽  
Clinical Features ◽  
Clinical Skills ◽  
Acute Respiratory Tract Infection ◽  
Clinical Findings ◽  
Clinical Predictors ◽  
Presumptive Treatment ◽  
Children Under Five ◽  
Under Five ◽  
Clinical Algorithms

Under the current guidelines of presumptive treatment of all children with reported fever, the risk of over-prescribing antimalarial drugs and missing other important causes of fever, like acute respiratory tract infection (ARI), is substantial. Clinical algorithms have been shown to be useful in diagnosing malaria, but often with differing results, due to regional variations. We set out to explore the clinical features associated with malaria compared with other febrile illnesses and specifically severe malaria with ARI in children under five in Pemba. Two hundred and seven children aged six months to five years presenting to a hospital clinic with fever were studied in Pemba. Clinical findings were related to the presence of malaria parasitaemia. Malaria accounted for 67.7% of the febrile episodes investigated. Five symptoms and signs, including pallor, drowsiness, splenomegaly, fever duration and no chest crackles, could accurately predict a case of malaria with a sensitivity of 91.3% and specificity of 53% and positive predictive value of 80.3%. Several clinical features were found to differentiate severe malaria from ARI. These results confirm that clinical algorithms can increase the diagnostic accuracy of malaria, although not sufficiently to replace microscopy, and by promoting the use of clinical skills other treatable causes of febrile illnesses may be identified. These findings could have implications in optimizing treatment and malaria control in children on Pemba.

scholarly journals Kualitas Fisik Rumah Dengan Kejadian Pneumonia Pada Balita

2019 ◽  
Vol 16 (2) ◽  
pp. 809
Author(s):  
Tri Nindia ◽  
Imam Santoso ◽  
Juanda Juanda
Keyword(s):  
Health Center ◽  
Acute Respiratory Tract Infection ◽  
Retrospective Case ◽  
Chi Square ◽  
Physical Quality ◽  
Children Under Five ◽  
Under Five ◽  
Lighting Conditions ◽  
Case Comparison ◽  
Relationship Of

Abstrack : Physical Quality Density Of Houses With The Incedents Of Pneumonia In Children Under Five. Toddler pneumonia is an acute respiratory tract infection that is inflammation or irritation in one or both lungs, caused by infection. An illness is said to be acute if it has lasted ± 14 days. The purpose of this study was to determine the relationship of physical quality of houses (lighting, temperature, and humidity) and occupancy density with the incidence of pneumonia in children under five in Kecamatan Astambul, Kabupaten Banjar. Analytical research design with approach retrospective ( case control study ) in case comparison: control 1: 1. The sample of cases in this study were all houses of pneumonia patients 25 houses in the Astambul Health Center area in November 2018 - January 2019. Data analysis used chi-square test.The results of the research statistic showed that the lighting conditions (p 0.321>α 0.05) had no relationship, the temperature conditions (p 0.244 >α 0.05) had no relationship, and the condition of humidity (p 1.00>α 0.05) have no relationship with the incidence of pneumonia in infants.It is expected that counseling from Astambul public health center to society so they can increase knowledge and awareness about the requirements of a healthy home and pay attention to the health of their home environment.

scholarly journals Management of uncomplicated malaria among children under five years at public and private sector facilities in Mali

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Seydou Fomba ◽  
Diakalia Koné ◽  
Bakary Doumbia ◽  
Diadier Diallo ◽  
Thomas Druetz ◽  
...  
Keyword(s):  
Case Management ◽  
Severe Malaria ◽  
Uncomplicated Malaria ◽  
Artemisinin Combination Therapy ◽  
Diagnostic Testing ◽  
Public And Private ◽  
Confirmatory Testing ◽  
Children Under Five ◽  
Under Five ◽  
Multiple Drugs

Abstract Background Prompt and effective malaria diagnosis and treatment is a cornerstone of malaria control. Case management guidelines recommend confirmatory testing of suspected malaria cases, then prescription of specific drugs for uncomplicated malaria and for severe malaria. This study aims to describe case management practices for children aged 1–59 months seeking treatment with current or recent fever from public and private, rural and urban health providers in Mali. Methods Data were collected at sites in Sikasso Region and Bamako. Health workers recorded key information from the consultation including malaria diagnostic testing and result, their final diagnosis, and all drugs prescribed. Children with signs of severe diseases were ineligible. Consultations were not independently observed. Appropriate case management was defined as both 1) tested for malaria using rapid diagnostic test or microscopy, and 2) receiving artemisinin combination therapy (ACT) and no other antimalarials if test-positive, or receiving no antimalarials if test-negative. Results Of 1602 participating children, 23.7% were appropriately managed, ranging from 5.3% at public rural facilities to 48.4% at community health worker sites. The most common reason for ‘inappropriate’ management was lack of malaria diagnostic testing (50.4% of children). Among children with confirmed malaria, 50.8% received a non-ACT antimalarial (commonly artesunate injection or artemether), either alone or in combination with ACT. Of 215 test-negative children, 44.2% received an antimalarial drug, most commonly ACT. Prescription of multiple drugs was common: 21.7% of all children received more than one type of antimalarial, while 51.9% received an antibiotic and antimalarial. Inappropriate case management increased in children with increasing axillary temperatures and those seeking care over weekends. Conclusions Multiple limitations in management of febrile children under five were identified, including inconsistent use of confirmatory testing and apparent use of severe malaria drugs for uncomplicated malaria. While we cannot confirm the reasons for these shortcomings, there is a need to address the high use of non-ACT antimalarials in this context; to minimize potential for drug resistance, reduce unnecessary expense, and preserve life-saving treatment for severe malaria cases. These findings highlight the challenge of managing febrile illness in young children in a high transmission setting.

scholarly journals DETERMINAN KEJADIAN ISPA NON PNEUMONIA PADA ANAK BALITA DI KELURAHAN KEDUNG SARI KECAMATAN SUKAJADI KOTA PEKANBARU

2019 ◽  
Vol 1 (2) ◽  
pp. 90-97
Author(s):  
Christine Vita Gloria Purba ◽  
Okta Safryanni ◽  
Al Hidayati ◽  
Zulmeliza Rasyid
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Cigarette Smoke ◽  
Health Workers ◽  
Acute Respiratory Tract Infection ◽  
Primary Data ◽  
P Value ◽  
Children Under Five ◽  
Under Five

Non pneumonia Acute Respiratory Tract Infection (ARI) is a respiratory tract disease that is acute with a cough that does not show symptoms of increased respiratory frequency and does not indicate the pull of the lower chest wall inward. The incidence of non pneumonia ARI  in children under five in Kedung Sari Village was recorded at 40.06%. This study aims to determine the description and determinant of the incidence of non-pneumonia ARI  in children under five in Kedung Sari Village, Sukajadi District, Pekanbaru City in 2019. This type of research is quantitative observational analytic with cross sectional design. The study population was all children under five who lived in Kedung Sari Village, Sukajadi District, Pekanbaru City, amounting to 312 people with a sample of 172 respondents. The sampling technique was done by consecutive sampling. The type of data used in this study are primary data and secondary data by means of retrieving data through measurements and questionnaires. Data analysis was done by univariate and bivariate with chi square test. The results showed that there was a correlation between exposure to cigarette smoke (p-value 0,000) and the incidence of non-pneumonia ARI in children under five. It is expected that health workers, especially in the health promotion section of the community health center in implementing control and eradication programs of Acute Respiratory Tract Infection can provide health education, especially regarding the dangers of cigarette smoke for children under five and recommend smokers to smoke in special places so children under five are not exposed cigarettes.

scholarly journals Molecular Epidemiology and Clinical Risk Factors of Rotavirus Diarrhea: Single Center 5-Year Experience

2021 ◽  
Author(s):  
Ekin Soydan ◽  
İlknur Çağla ◽  
Mine Düzgol ◽  
Hurşit Apa ◽  
İlker Devrim ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Laboratory Data ◽  
Clinical Findings ◽  
Study Data ◽  
Children Under Five ◽  
Under Five ◽  
Common Causes ◽  
Training And Research ◽  
Rotavirus Diarrhea

Objective: Acute gastroenteritis due to the rotavirus is one of the common causes of morbidity and mortality in children under five years of age. The objective of this study was to evaluate the epidemiological, clinical, and laboratory data of rotavirus diarrhea in hospitalized children under five years of age. Methods: All children between one month and 60 months old ages who were hospitalized in Health Sciences University Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital during September 2013 to August 2017 and diagnosed as acute gastroenteritis with rotavirus antigen test positive in feces were included in the current study. Data of the patients were collected retrospectively from medical records. Results: A total of 100 patients were evaluated.The median age of the patients was 13 months (IQR 5-45 months) and 54 patients were male and 46 were female.The highest hospitalization rate was in December, followed by November, and in October. The most common type of G9P (8) serotype was detected in rotavirus serotype analysis by PCR. Breastfeeding infants had milder clinic findings in comparison to the older ones. It was found that clinical findings were milder and Vesicari score was lower in infants who had breast milk. Vesikari score was found to be high in children with severe clinical findings. Conclusion: Rotavirus infection is important for all ages.In case of fever, increased numbers of vomiting and diarrhea, and higher Vesikari system scores may be associated with the severe clinical forms. Determination of rotavirus serotypes and clinical monitoring of genotypic changes are required.

scholarly journals A Study on the Use of Abdominal X-Ray in an Emergency Department

2002 ◽  
Vol 9 (1) ◽  
pp. 30-33 ◽  
Author(s):  
Sy Choi ◽  
Tw Wong ◽  
Cc Lau ◽  
E Liang ◽  
Yk Fu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Clinical Features ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Abdominal Distension ◽  
Clinical Findings ◽  
Bowel Sound ◽  
X Rays ◽  
Clinical Predictors ◽  
X Ray

Objective 1) To study the current use of abdominal X-rays (AXR) in our emergency department (ED). 2) To evaluate the clinical predictors for positive AXR findings. Methods During the 40 days study period, all patients who had taken abdominal X-rays were included. The attending doctor filled in a questionnaire on demographic data, clinical features and outcome. The three radiologists who participated in this study reported the films and consultant emergency physicians then commented on the appropriateness of the request. The clinical features, which were predictive of positive radiological findings, were sorted out using univariate analysis. Results 64 patients were included in the 40 days study period. The rate for AXR request was 3.4 per 1000 patients. The most common presenting complaints were abdominal pain (85.9%) and constipation (45.3%). The most frequent clinical findings were abdominal distension (35.9%) and hyperactive bowel sound (31.3%). Only two of the clinical features, including vomiting and rebound tenderness, were found to have significant correlation with positive X-ray findings. Most of the AXR requests and interpretations by ED doctors were considered to be appropriate.

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