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The Use of Guidelines for Lower Respiratory Tract Infections in Tanzania: A Lesson from Kilimanjaro Clinicians
B Mbwele1, A Slot2, Q De Mast2
1Kilimanjaro Christian Medical Center, Kilimanjaro Clinical Research Institute, Zanzibar, Tanzania; Programme Manager - Reproductive Maternal Newborn Child Health, Nutrition and WASH, Save the Children, Zanzibar, Tanzania.
Background:
Evaluations of the guidelines for the management of Lower Respiratory Tract Infections (LRTI) Sub-Saharan Africa, particularly in Tanzania is scant.
Aim:
The aim of the study was to assess the usefulness of the current Tanzanian treatment guideline for the management lower respiratory tract infection.
Subjects And Methods:
A descriptive cross sectional study in 11 hospitals of different levels in the Kilimanjaro region Data were collected from May 2012 to July 2012 by semi-structured interview for clinicians using 2 dummy cases for practical assessment. Data were analyzed by STATA v11 (StataCorp, TX, USA). Qualitative narratives from the interviews were translated, transcribed then coded by colors into meaningful themes.
Results:
A variety of principles for diagnosing and managing LRTI were demonstrated by 53 clinicians of Kilimanjaro. For the awareness, 67.9% (36/53) clinicians knew their responsibility to use Standard Treatment Guideline for managing LRTI. The content derived from Standard Treatment Guideline could be cited by 11.3% of clinicians (6/53) however they all showed concern of gaps in the guideline. Previous training in the management of patients with LRTI was reported by 25.9% (14/53), majority were pulmonary TB related. Correct microorganisms causing different forms of LRTI were mentioned by 11.3% (6/53). Exact cause of Atypical pneumonia and Q fever as an example was stated by 13.0% (7/53) from whom the need of developing the guideline for LRTI was explicitly elaborated.
Conclusion:
The current guidelines have not been used effectively for the management of LRTI in Tanzania. There is a need to review its content for the current practical use.
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