Care at first-level facilities for children with severe pneumonia in Bangladesh: a cohort study

Lancet
Enayet K ChowdhuryRobert E Black

Abstract

Guidelines on integrated management of childhood illness (IMCI) for severe pneumonia recommend referral to hospitals. However, in many settings, children who are referred do not actually attend hospital, which severely limits appropriate care. We aimed to assess the safety and effectiveness of modified guidelines that allowed most children with severe pneumonia to be treated locally in first-level facilities, with referral only for those with danger signs or other severe classifications. We did an observational cohort study in ten first-level health facilities in Matlab, rural Bangladesh that had implemented IMCI guidelines. We assessed children with severe pneumonia who were aged between 2 and 59 months, and for whom we could obtain complete information, in two cohorts: 261 children who presented to these facilities between May, 2003, and April, 2004 (before implementation of the modified guidelines) and 1271 children between September, 2004, and August, 2005 (after full implementation). We obtained information about the characteristics and management of their illness, including referrals and admissions to hospital, from facility records. Staff visited households to obtain details of treatment, socioeconomic information, and f...Continue Reading

Citations

Aug 7, 2013·Global Public Health·Rosette J ChakkalakalElizabeth H Bradley
Dec 25, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Matthew P FoxUNKNOWN Pneumonia Studies Group
Nov 21, 2012·The American Journal of Tropical Medicine and Hygiene·Salim SadruddinShamim Qazi
Apr 16, 2013·Lancet·Christa L Fischer WalkerRobert E Black
Jan 31, 2012·Lancet·Robert E Black, Shams El Arifeen
Aug 22, 2008·Lancet·Igor Rudan, Harry Campbell
May 20, 2015·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Sozinho AcácioBetuel Sigaúque
Jul 21, 2011·Asian Pacific Journal of Tropical Medicine·C H RasulR U Zaman
Aug 4, 2011·Cadernos de saúde pública·Andrey Moreira CardosoRicardo Ventura Santos
Jul 6, 2016·The Cochrane Database of Systematic Reviews·Tarun GeraHarshpal S Sachdev
Jan 9, 2020·Antimicrobial Resistance and Infection Control·D DonàM Sharland
Dec 1, 2014·Pneumonia·Kerry-Ann F O'GradyAnne B Chang

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