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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Acute undifferentiated fever in Binh Thuan province, Vietnam: Imprecise clinical diagnosis and irrational pharmaco-therapy
Tropical Medicine and International Health, Volume 11, No. 6, Year 2006
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Description
OBJECTIVES: To describe the characteristics of patients consulting commune primary healthcare posts for acute undifferentiated fever not being malaria (AUF), and to explore the diagnostic and therapeutic responses of the healthcare workers. METHODS: All patients presenting with AUF at 12 commune health posts and one clinic at the provincial malaria station, Binh Thuan, a dengue endemic province in southern Vietnam, were included. Record forms were used to fill in patient and diseases characteristics, pre-referral treatment, signs and symptoms, provisional diagnosis and installed treatment, referral and final outcome. RESULTS: Two thousand ninety-six patients were included from April 2001 to March 2002. The median delay to attend the health posts was, 0.87 day for >5, 1.15 days for children aged 5-15 years and 1.41 days for adults (P < 0.001). Sixty-five per cent of patients took some measures before consulting the health post, of whom 82% applied self-medication and 69% took antibiotics. Pre-referral medication with antibiotics increased with age (RR 1.012 per year of age; 95% CI: 1.004-1.019). The diagnostic and therapeutic response of healthcare workers was very unspecific. The tourniquet test was inappropriately used as general discriminating test, not only for detecting dengue haemorrhagic fever. Empiric antibiotic therapy was installed in 77.2% of cases. CONCLUSIONS: Management of uncomplicated fever, not being malaria, at the primary healthcare level in Vietnam is non-specific, dominated by searching signs of hemorrhagic dengue and empiric antibiotic treatment. This can probably be improved by better education. © 2006 Blackwell Publishing Ltd.
Authors & Co-Authors
Phuöng, Hoanglan
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Viet Nam, Ho Chi Minh City
Cho Ray Hospital
de Vries, Peter J.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Nagelkerke, Nico J.D.
United Arab Emirates, Al Ain
United Arab Emirates University
Giao, Phan Trong
Viet Nam, Ho Chi Minh City
Cho Ray Hospital
Hung, Lequoc
Viet Nam, Ho Chi Minh City
Cho Ray Hospital
Binh, Tran Quang
Viet Nam, Ho Chi Minh City
Cho Ray Hospital
Nga, Tran Vu Thieu
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Viet Nam, Ho Chi Minh City
Cho Ray Hospital
van Nam, Nguyenvan
Viet Nam
Binh Thuan Malaria and Goiter Control Center
Kager, Petrus A.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Statistics
Citations: 46
Authors: 9
Affiliations: 4
Identifiers
Doi:
10.1111/j.1365-3156.2006.01636.x
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health