Poor adherence to the World Health Organization guidelines of treatment of severe pneumonia in children at Khartoum, Sudan

BMC Research Notes

Ishag Adam⁶  Salah A Ibrahim⁶  Elfatih Elsammani³  Widad Eldouch¹  Yassin Hamid⁵  Mona A Alfadeel⁴  Jalal A Bilal⁷  Karim Eldin M Salih² 

[1] Department of epidemiology, Federal Ministry of Health, Khartoum, Sudan;Department of Pediatrics, College of Medicine, King Khalid University, Abha, Saudi Arabia;Department of Epidemiology, School of Medicine, Ahfad University for Women, Omdurman, Sudan;King Khalid University Hospital, Riyadh, Saudi Arabia;Almaarifa College for Science and Technology, Khartoum Children, Riyadh, Saudi Arabia;Faculty of Medicine, University of Khartoum, Khartoum, Sudan;College of Medicine, Qassim University, Buraydah, Saudi Arabia

关键词: Sudan;    Penicillin;    Adherence;    Treatment;    Pneumonia;   

Others  :  1130492
DOI  :  10.1186/1756-0500-7-531

 received in 2014-07-27, accepted in 2014-08-11,  发布年份 2014

【 摘 要 】

Background

Community-acquired pneumonia (CAP) is as a major cause for childhood morbidity and mortality worldwide. This study was conducted to investigate the adherence and response of the WHO guidelines for treatment of severe pneumonia.

Method

A cross-sectional study was conducted in the period of June 2009 to July 2010 at Khartoum Hospital, Sudan. Children admitted and treated for severe pneumonia were enrolled.

Results

Only 39 (18.8%) out of 208 enrolled children received prescriptions that were adherent to the WHO guidelines of treatment of severe pneumonia. In logistic regression none of the investigated variable (age, gender, and clinical presentations) was associated with the adherence to the WHO guidelines. There was no significant difference in the response between adherent and non-adherent prescriptions. There was no association between the demographic, clinical data, treatment-adherence to the guidelines and the patients’ response.

Conclusion

There is a poor (18.8%) adherence to the WHO guidelines of the treatment of severe pneumonia in the region regardless to the age, gender and clinical presentation.

【 授权许可】

   
2014 Salih et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]British Thoracic Society Standards of Care Committee: BTS Guidelines for the Management of Community Acquired Pneumonia in Childhood. Thorax 2002, 57(Suppl. 1):i1-i23.
• [2]Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H: Epidemiology and etiology of childhood pneumonia. Bull World Health Organ 2008, 86:408-416.
• [3]Manikam L, Lakhanpaul M: Epidemiology of community acquired pneumonia. J Paediatr Child Health 2012, 22:299-306.
• [4]Korppi M: Community-acquired pneumonia in children: issues in optimizing antibacterial treatment. Paediatr Drugs 2003, 5:821-832.
• [5]World Health Organization: Country Cooperation Strategy for WHO and Sudan, 2008–2013. Available at: http://www.who.int/countryfocus/cooperation_strategy/ccs_sdn_en.pdf webcite
• [6]WHO: Pocket book of hospital care for children: guidelines for the management of common illnesses with limited resources. Geneva: World Health Organization; 2005. http://www.who.int/maternal_child_adolescent/documents/child_hospital_care/en/ webcite (accessed Oct 21, 2013)
• [7]Garfield FB, Garfield JM: Clinical judgment and clinical practice guidelines. Int J Technol Assess Health Care 2000, 16:1050-1060.
• [8]The fifth population census data: Sudan Central Bureau of statistics. 2008. Available from: http://www.cbs.gov.sd/en/ webcite
• [9]Commission on Information and Accountability for Women's and Children's Health: Keeping promises, measuring results. 2011. http://www.everywomaneverychild.org/images/content/files/accountability_commission/final_report/Final_EN_Web.pdf webcite. Accessed 4 December 2013
• [10]WHO: The Rational Use of Drugs - Report of the Conference of Experts, Nairobi 25–29 November 1985. Geneva: World Health Organization; 1987.
• [11]Sudanese Association of Paediatricians: Management Protocols for Paediatric Emergency. Sudan Association of Paediatricians and Advisory committee of paediatricians. 2nd edition. 2011, 32-33. Available from: http://www.sudanjp.org/uploads/9/2/7/0/9270568/paediatric_emergency_guidelines.pdf webcite
• [12]Ilboudo TB, Chou Y, Huang N: Assessment of providers' referral decisions in Rural Burkina Faso: a retrospective analysis of medical records. BMC Health Serv Res 2012, 12:54. BioMed Central Full Text
• [13]Gwimile JJ, Shekalaghe SA, Kapanda GN, Kisanga ER: Antibiotic prescribing practice in management of cough and/or diarrhea in Moshi Municipality, Northern Tanzania: cross-sectional descriptive study. Pan Afr Med J 2012, 12:103.
• [14]Mol PG, Denig P, Gans RO, Nannanpanday PV, Degener JE, Laseur M, Haaijer-Ruskamp FM: Limited effect of patient and disease characteristics on compliance with hospital antimicrobial guidelines. Eur J Clin Pharmacol 2006, 62:297-305.
• [15]English M, Esamai F, Wasunna A, Were F, Ogutu B, Wamae A, Snow RW, Peshu N: Delivery of paediatric care at the first-referral level in Kenya. Lancet 2004, 364:1622-1629.
• [16]Irimu GW, Gathara D, Zurovac D, Kihara H, Maina C, Mwangi J, Mbori-Ngacha D, Todd J, Greene A, English M: Performance of Health Workers in the Management of Seriously Sick Children at a Kenyan Tertiary Hospital: Before and after a training intervention. PLoS One 2012, 7(7):e39964.
• [17]Krause G, Borchert M, Benzler J, Diesfeld HJ: From diagnosis to drug taking: staff compliance with guidelines and patient compliance to prescriptions in Burkina Faso. Int J Qual Health Care 2000, 12(1):25-30.
• [18]Kristiansson C, Reilly M, Gotuzzo E, Rodriguez H, Bartoloni A, Thorson A, Falkenberg T, Bartalesi F, Tomson G, Larsson M: Antibiotic use and health-seeking behaviour in an underprivileged area of Peru. Trop Med Int Health 2008, 13:434-441.
• [19]Cheraghali AM, Idries AM: Availability, affordability, and prescribing pattern of medicines in Sudan. Pharm World Sci 2009, 31:209-215.
• [20]Nijman RG, Vergouwe Y, Thompson M, Van Veen M, Van Meurs AH, van der Lei J, Steyerberg EW, Moll HA, Oostenbrink R: Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: diagnostic study. BMJ 2013, 346:f1706.
• [21]Nacul LC, Kirkwood BR, Carneiro AC, Pannuti CS, Magalhaes M, Arthur PA: Etiology and clinical presentation of pneumonia in hospitalized and outpatient children in Northeast Brazil and risk factors for severity. J Health Popul Nutr 2005, 23:6-15.