Your browser doesn't support javascript.
loading
Prevalence and correlates of paediatric guideline non-adherence for initial empirical care in six low and middle-income settings: a hospital-based cross-sectional study.
Shawon, Riffat Ara; Denno, Donna; Tickell, Kirkby D; Atuhairwe, Michael; Bandsma, Robert; Mupere, Ezekiel; Voskuijl, Wieger; Mbale, Emmie; Ahmed, Tahmeed; Chisti, Md Jobayer; Saleem, Ali Faisal; Ngari, Moses; Diallo, Abdoulaye Hama; Berkley, James; Walson, Judd; Means, Arianna Rubin.
Afiliación
  • Shawon RA; Epidemiology, University of Washington, Seattle, Washington, USA riasha47@gmail.com.
  • Denno D; Global Health, University of Washington, Seattle, Washington, USA.
  • Tickell KD; Global Health, University of Washington, Seattle, Washington, USA.
  • Atuhairwe M; Pediatrics, University of Washington, Seattle, Washington, USA.
  • Bandsma R; Childhood Acute Illness and Nutrition Network, Nairobi, Kenya.
  • Mupere E; Epidemiology, University of Washington, Seattle, Washington, USA.
  • Voskuijl W; Global Health, University of Washington, Seattle, Washington, USA.
  • Mbale E; Childhood Acute Illness and Nutrition Network, Nairobi, Kenya.
  • Ahmed T; Childhood Acute Illness and Nutrition Network, Nairobi, Kenya.
  • Chisti MJ; Uganda-Case Western Reserve University Research Collaboration, Makerere University, Kampala, Uganda.
  • Saleem AF; Childhood Acute Illness and Nutrition Network, Nairobi, Kenya.
  • Ngari M; Centre for Global Child Health, Toronto, Ontario, Canada.
  • Diallo AH; Childhood Acute Illness and Nutrition Network, Nairobi, Kenya.
  • Berkley J; Uganda-Case Western Reserve University Research Collaboration, Makerere University, Kampala, Uganda.
  • Walson J; Paediatrics and Child Health, Makerere University, Kampala, Uganda.
  • Means AR; Childhood Acute Illness and Nutrition Network, Nairobi, Kenya.
BMJ Open ; 14(3): e078404, 2024 Mar 08.
Article en En | MEDLINE | ID: mdl-38458789
ABSTRACT

OBJECTIVES:

This study evaluated the prevalence and correlates of guideline non-adherence for common childhood illnesses in low-resource settings. DESIGN AND

SETTING:

We used secondary cross-sectional data from eight healthcare facilities in six Asian and African countries.

PARTICIPANTS:

A total of 2796 children aged 2-23 months hospitalised between November 2016 and January 2019 with pneumonia, diarrhoea or severe malnutrition (SM) and without HIV infection were included in this study. PRIMARY OUTCOME

MEASURES:

We identified children treated with full, partial or non-adherent initial inpatient care according to site-specific standard-of-care guidelines for pneumonia, diarrhoea and SM within the first 24 hours of admission. Correlates of guideline non-adherence were identified using generalised estimating equations.

RESULTS:

Fully adherent care was delivered to 32% of children admitted with diarrhoea, 34% of children with pneumonia and 28% of children with SM when a strict definition of adherence was applied. Non-adherence to recommendations was most common for oxygen and antibiotics for pneumonia; fluid, zinc and antibiotics for diarrhoea; and vitamin A and zinc for SM. Non-adherence varied by site. Pneumonia guideline non-adherence was more likely among patients with severe disease (OR 1.82; 95% CI 1.38, 2.34) compared with non-severe disease. Diarrhoea guideline non-adherence was more likely among lower asset quintile groups (OR 1.16; 95% CI 1.01, 1.35), older children (OR 1.10; 95% CI 1.06, 1.13) and children presenting with wasting (OR 6.44; 95% CI 4.33, 9.57) compared with those with higher assets, younger age and not wasted.

CONCLUSIONS:

Non-adherence to paediatric guidelines was common and associated with older age, disease severity, and comorbidities, and lower household economic status. These findings highlight opportunities to improve guidelines by adding clarity to specific recommendations.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía / Infecciones por VIH Límite: Adolescent / Child / Humans Idioma: En Revista: BMJ Open Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía / Infecciones por VIH Límite: Adolescent / Child / Humans Idioma: En Revista: BMJ Open Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido