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Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/69250
Under treatment of pneumonia among children under 5 years of age in a malaria-endemic area: population-based surveillance study conducted in Manhica district- rural, Mozambique
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BACKGROUND: Integrated Management of Childhood Illness (IMCI)
guidelines were developed to decrease morbidity and mortality,
yet implementation varies across settings. Factors associated
with poor adherence are not well understood. METHODS: We used
data from Manhica District Hospital outpatient department and
five peripheral health centers to examine pneumonia management
for children <5 years old from January 2008 to June 2011.
Episodes of IMCI-defined pneumonia (cough or difficult breathing
plus tachypnea), severe pneumonia (pneumonia plus chest wall
in-drawing), and/or clinician-diagnosed pneumonia (based on
discharge diagnosis) were included. RESULTS: Among severe
pneumonia episodes, 96.2% (2,918/3,032) attended in the
outpatient department and 70.0% (291/416) attended in health
centers were appropriately referred to the emergency department.
Age<1 year, malnutrition and various physical exam findings
were associated with referral. For non-severe pneumonia
episodes, antibiotics were prescribed in 45.7% (16,094/35,224).
Factors associated with antibiotic prescription included age
<1 year, abnormal auscultatory findings, and clinical
diagnosis of pneumonia; diagnosis of malaria or gastroenteritis
and pallor were negatively associated with antibiotic
prescription. CONCLUSION: Adherence to recommended management of
severe pneumonia was high in a hospital outpatient department,
but suboptimal in health centers. Antibiotics were prescribed in
fewer than half of non-severe pneumonia episodes, and diagnosis
of malaria was the strongest risk factor for incorrect
management.
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ACÁCIO, Sozinho, et al. Under treatment of pneumonia among children under 5 years of age
in a malaria-endemic area: population-based surveillance study
conducted in Manhica district- rural, Mozambique. International Journal of Infectious Diseases. 2015. Vol. 36, num. 39-45. ISSN 1201-9712. [consulted: 8 of August of 2026]. Available at: https://hdl.handle.net/2445/69250