Management of uncomplicated malaria in children under 13 years of age at a district hospital in senegal: from official guidelines to usual practicesReport as inadecuate




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Malaria Journal

, 10:285

First Online: 29 September 2011Received: 21 June 2011Accepted: 29 September 2011

Abstract

BackgroundTo be effective, national malaria guidelines must be properly followed. This study evaluated nurses- practices in the management of uncomplicated malaria cases at a District Hospital. Its objective was to identify the reasons for discrepancies between official guidelines and usual practices.

MethodsThis study took place at Oussouye hospital, south-western Senegal. Blood smears were available for biological diagnosis in patients aged more than five years while the Integrated Management of Childhood Illness recommended treating fevers presumptively in children under five. First line anti-malarial was Amodiaquine plus sulphadoxine-pyrimethamine AQ+SP bi-therapy. Hospital records of children under 13 years of age seen between 2004 and 2005 were reviewed.

ResultsAmong children treated with anti-malarials, 74% 2, 063-2, 789 received AQ+SP. However, only 22% 406-1, 879 of febrile children and 19% 429-2, 198 of children diagnosed with malaria got a blood smear. Moreover, an anti-malarial was prescribed for 80% 377-474 of children with a negative blood smear.

ConclusionsThe transition from chloroquine to AQ+SP was well followed. Nonetheless, blood smear use was very low and many over-prescriptions were reported. Reasons for discrepancies between guidelines and practices can be classified in three main categories: ambiguous guidelines, health system-s dysfunctions and nurses- own considerations. Aside from the strengthening of the public health system, in order to guarantee practices complying with guidelines, training content should be more adapted to nurses- own considerations.

Electronic supplementary materialThe online version of this article doi:10.1186-1475-2875-10-285 contains supplementary material, which is available to authorized users.

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Author: Sophie Sarrassat - Richard Lalou - Moustapha Cissé - Jean-Yves Le Hesran

Source: https://link.springer.com/







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