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ADHERENCE TO PNEUMONIA GUIDELINES FOR CHILDREN 2 - 59 MONTHS AT GARRISA PROVINCIAL GENERAL HOSPITAL
East African Medical Journal
|February 11, 2016
Summary
Adherence to national pneumonia management guidelines in Kenyan children aged 2-59 months was low. Disease severity and co-morbidities were linked to better adherence in this study.
Area of Science:
- Pediatrics
- Public Health
- Infectious Diseases
Background:
- Kenya's Ministry of Health Basic Paediatric Protocols outline guidelines for childhood illnesses, including pneumonia.
- Pneumonia diagnosis and classification into severe and very severe forms are based on clinical signs like respiratory rate, chest wall indrawing, and cyanosis.
- Dissemination of these guidelines through Emergency Triage And Treatment Plus (ETAT +) courses since 2007 has shown potential to reduce case fatality by 36%.
Purpose of the Study:
- To evaluate adherence to national pneumonia management guidelines for children aged two to fifty-nine months at Garissa Provincial General Hospital, Kenya.
- To identify factors influencing adherence to these pediatric pneumonia guidelines.
Main Methods:
- A retrospective, hospital-based, cross-sectional study was conducted.
- Medical records of 91 children aged two to fifty-nine months diagnosed with pneumonia between January and June 2012 were reviewed.
- Data included demographics, clinical signs, disease classification, and treatment, assessing adherence at assessment, classification, and treatment stages.
Main Results:
- Overall guideline adherence averaged 42.9%.
- Correct disease severity classification was documented in 56.6% of cases, and recommended treatment was prescribed in 27.7%.
- Better adherence to assessment tasks was associated with co-morbidity (p=0.033) and severe disease (p=0.021). Disease severity also correlated with better classification (p<0.001) and treatment adherence (p=0.02).
Conclusions:
- Adherence to national pneumonia management guidelines was low across all assessed levels.
- Disease severity emerged as a significant factor associated with improved guideline adherence.
- The presence of co-morbidities positively influenced disease assessment adherence.
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