FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2890732779> ?p ?o ?g. }

• W2890732779 abstract "BackgroundMalaria and pneumonia are the leading causes of under-five mortality in sub-Saharan Africa especially in Nigeria. The Integrated Management of Childhood Illness (IMCI) guidelines were developed by the World Health Organisation (WHO)/United Nations Children’s Fund (UNICEF) as a strategy to reduce the burden of these and other preventable childhood diseases. However, there appears to be a paucity of evidence on the diagnostic performance of the revised IMCI guidelines and whether they offer an advantage over lay diagnosis (caregiver) for malaria and pneumonia management in Nigeria.Aim and specific objectivesThis study evaluates early diagnostic approaches (IMCI guidelines and lay diagnosis) for malaria and pneumonia in children under-five at the primary healthcare level. To address the overarching aim of the study, the following four specific objectives were studied:I. To assess the diagnostic accuracy of the IMCI guidelines and lay diagnosis (caregiver) for malaria and pneumonia in comparison to reference diagnostic approaches (microscopy and chest X-ray for malaria and pneumonia respectively). The extent of agreement between caregivers’ and health workers’ diagnosis of malaria and pneumonia is also assessed.II. To estimate the burden of malaria and pneumonia among children under-five presenting to study primary healthcare centres (PHCs) according to various diagnostic approaches. III. To determine the clinical outcomes in children diagnosed with malaria and pneumonia according to the IMCI guidelines and risk factors for severe outcomes. IV. To qualitatively explore caregivers’ and health professionals’ perspectives on lay diagnosis and IMCI guidelines as diagnostic approaches for childhood malaria and pneumonia.MethodsA mixed methods approach was used for this study. The quantitative component used a consecutive sampling approach to recruit 903 children aged 2–59 months who met study eligibility criteria for malaria and pneumonia assessment according to the IMCI guidelines at presentation to five study PHCs in Benin City, Nigeria. Caregivers of these children were also asked what they thought the diagnosis was (lay diagnosis). Diagnostic accuracy was assessed in terms of sensitivity, specificity, positive and negative predictive values, Area under the Receiver Operating Characteristic Curves (AUROC) values and 95% Confidence Intervals (C.I). The extent of agreement was assessed in terms of Cohen’s kappa statistic (k) and 95% CI. The estimated burden of malaria and pneumonia during the study period was assessed using proportions and 95% C.I. Clinical outcomes in children diagnosed with malaria and pneumonia by the IMCI guidelines were described in terms of frequency and percentages, while the potential risk factors associated with clinical outcomes were assessed using odds ratios (ORs) and 95% C.I. For the qualitative component, health stakeholders (17 health professionals and 13 caregivers) who met the study eligibility criteria were purposively recruited and interviewed using semi-structured interviews. An inductive approach to thematic analysis was used for data analysis.ResultsCompared to microscopy, the diagnosis of malaria by health workers using the IMCI guidelines was poorly accurate with an AUROC value of 0.57 (with sensitivity and specificity of 51.8% and 61.3% respectively). Similarly, caregivers’ diagnosis of malaria was poor with an AUROC value of 0.55 (with sensitivity and specificity of 31.1% and 79.5% respectively) as compared to microscopy. Using the IMCI guidelines as the reference diagnostic test, caregivers’ diagnosis of malaria was more accurate (AUROC 0.60) in comparison to that of pneumonia (AUROC 0.54). There was a slight or minimal level of agreement (k=0.14; 95% CI: 0.09-0.19) between caregivers and health workers in the diagnosis of malaria and pneumonia. The estimated burden of malaria and pneumonia was relatively low, varying by the study local government areas, PHCs and seasonality, irrespective of the diagnostic approach. Where follow-up data were available, approximately 57% (172/304) and 78% (81/104) of the children diagnosed with malaria and pneumonia, respectively, recovered without complications within 30 days. Self-medication prior to presenting to study PHCs and use of preventive measures against malaria were independently and significantly associated with improved clinical outcomes. In contrast, exposure to solid fuels increased the odds of severe illness following malaria or pneumonia diagnosis.The qualitative component of the study found that caregivers rely on lay diagnosis despite the awareness of its limitations. The perceptions of malaria and pneumonia appeared to influence caregivers’ home management practices and health seeking behaviours. Caregivers showed willingness to be trained in the IMCI guidelines for improved home-based management of malaria and pneumonia. Health professionals believed that the IMCI guidelines were useful for managing both malaria and pneumonia. However, there are some recurring challenges to the wide-scale and sustainable implementation of the IMCI strategy in Nigeria. These include inaccurate diagnosis of malaria and inadequate funding.ConclusionThe IMCI guidelines are crucial in the effective management (diagnosis and treatment) of malaria and pneumonia at the primary healthcare level in Nigeria. Although not perfect, lay diagnosis has an important contribution in the early detection and management of malaria and pneumonia at the community level in Nigeria. However, there is need for further investment in the training of both health professionals and caregivers in the IMCI guidelines for better health outcomes in under-five population. The training of caregivers in the IMCI guidelines and potential for a scale-up will benefit from careful design, piloting, implementation, and monitoring." @default.
• W2890732779 created "2018-09-27" @default.
• W2890732779 creator A5048614892 @default.
• W2890732779 date "2018-07-12" @default.
• W2890732779 modified "2023-09-26" @default.
• W2890732779 title "Evaluation of early diagnostic approaches for malaria and pneumonia in children under-five presenting at the primary healthcare level in Benin City, Nigeria : a mixed methods study" @default.
• W2890732779 hasPublicationYear "2018" @default.
• W2890732779 type Work @default.
• W2890732779 sameAs 2890732779 @default.
• W2890732779 citedByCount "0" @default.
• W2890732779 crossrefType "dissertation" @default.
• W2890732779 hasAuthorship W2890732779A5048614892 @default.
• W2890732779 hasConcept C126322002 @default.
• W2890732779 hasConcept C160735492 @default.
• W2890732779 hasConcept C162324750 @default.
• W2890732779 hasConcept C163432668 @default.
• W2890732779 hasConcept C177713679 @default.
• W2890732779 hasConcept C187212893 @default.
• W2890732779 hasConcept C203014093 @default.
• W2890732779 hasConcept C2776408227 @default.
• W2890732779 hasConcept C2777914695 @default.
• W2890732779 hasConcept C2778048844 @default.
• W2890732779 hasConcept C2778371730 @default.
• W2890732779 hasConcept C2779810223 @default.
• W2890732779 hasConcept C2780261877 @default.
• W2890732779 hasConcept C2781081971 @default.
• W2890732779 hasConcept C2908647359 @default.
• W2890732779 hasConcept C46299933 @default.
• W2890732779 hasConcept C50522688 @default.
• W2890732779 hasConcept C71924100 @default.
• W2890732779 hasConcept C99454951 @default.
• W2890732779 hasConceptScore W2890732779C126322002 @default.
• W2890732779 hasConceptScore W2890732779C160735492 @default.
• W2890732779 hasConceptScore W2890732779C162324750 @default.
• W2890732779 hasConceptScore W2890732779C163432668 @default.
• W2890732779 hasConceptScore W2890732779C177713679 @default.
• W2890732779 hasConceptScore W2890732779C187212893 @default.
• W2890732779 hasConceptScore W2890732779C203014093 @default.
• W2890732779 hasConceptScore W2890732779C2776408227 @default.
• W2890732779 hasConceptScore W2890732779C2777914695 @default.
• W2890732779 hasConceptScore W2890732779C2778048844 @default.
• W2890732779 hasConceptScore W2890732779C2778371730 @default.
• W2890732779 hasConceptScore W2890732779C2779810223 @default.
• W2890732779 hasConceptScore W2890732779C2780261877 @default.
• W2890732779 hasConceptScore W2890732779C2781081971 @default.
• W2890732779 hasConceptScore W2890732779C2908647359 @default.
• W2890732779 hasConceptScore W2890732779C46299933 @default.
• W2890732779 hasConceptScore W2890732779C50522688 @default.
• W2890732779 hasConceptScore W2890732779C71924100 @default.
• W2890732779 hasConceptScore W2890732779C99454951 @default.
• W2890732779 hasLocation W28907327791 @default.
• W2890732779 hasOpenAccess W2890732779 @default.
• W2890732779 hasPrimaryLocation W28907327791 @default.
• W2890732779 hasRelatedWork W155194455 @default.
• W2890732779 hasRelatedWork W1935478862 @default.
• W2890732779 hasRelatedWork W2014991442 @default.
• W2890732779 hasRelatedWork W2026789886 @default.
• W2890732779 hasRelatedWork W2098600982 @default.
• W2890732779 hasRelatedWork W2102095191 @default.
• W2890732779 hasRelatedWork W2130409941 @default.
• W2890732779 hasRelatedWork W2140654386 @default.
• W2890732779 hasRelatedWork W2256599851 @default.
• W2890732779 hasRelatedWork W2330163592 @default.
• W2890732779 hasRelatedWork W2771493685 @default.
• W2890732779 hasRelatedWork W2908436632 @default.
• W2890732779 hasRelatedWork W2949941379 @default.
• W2890732779 hasRelatedWork W2969920575 @default.
• W2890732779 hasRelatedWork W2994419507 @default.
• W2890732779 hasRelatedWork W3008846280 @default.
• W2890732779 hasRelatedWork W3029687373 @default.
• W2890732779 hasRelatedWork W3042784625 @default.
• W2890732779 hasRelatedWork W3099464682 @default.
• W2890732779 hasRelatedWork W3209353202 @default.
• W2890732779 isParatext "false" @default.
• W2890732779 isRetracted "false" @default.
• W2890732779 magId "2890732779" @default.
• W2890732779 workType "dissertation" @default.