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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Can community health workers and caretakers recognise pneumonia in children? Experiences from western Uganda
Transactions of the Royal Society of Tropical Medicine and Hygiene, Volume 100, No. 10, Year 2006
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Description
Acute respiratory infections (ARI) are leading killers of children. Case management using community health workers (CHW) has halved ARI mortality in children in Asia. WHO/UNICEF recommend integrating pneumonia into Home Management of Malaria strategies. However, in sub-Saharan Africa, CHW's performance to recognise pneumonia is rarely demonstrated. We evaluated the ability of CHWs to assess rapid breathing in under 5 year olds and explored caretaker interpretation of pneumonia symptoms. Ninety-six CHWs were evaluated for their skills to count and classify breathing rate in inpatient children. Respiratory illness concepts and actions were obtained from focus group discussions with mothers, video probing and key informant interviews. Of the CHW assessments, 71% were within ±5 breaths/min from the gold standard. The sensitivity of CHW classification was 75% and the specificity was 83%. Many local terms existed for ARIs, such as 'quick breathing' and 'groaning breathing'. There was consistency in the interpretation of severity, cause and treatment, most being related to fever and treated with antimalarials. Given the ability of CHWs to classify pneumonia, their skills should be tested in real life. To minimise failure to treat and overtreatment, context-specific communication strategies that improve care-seeking and increase illness prevalence among patients assessed by CHWs are needed. A toolkit including a set of methods for this purpose is proposed. © 2005 Royal Society of Tropical Medicine and Hygiene.
Authors & Co-Authors
Källander, Karin
Sweden, Stockholm
Karolinska Institutet
Tomson, Göran B.
Sweden, Stockholm
Karolinska Institutet
Nsabagasani, Xavier
Uganda, Kampala
Uganda Programme for Human and Holistic Development Uphold
Uganda, Kampala
Makerere University
Sabiiti, Jesca Nsungwa
Sweden, Stockholm
Karolinska Institutet
Uganda, Kampala
Makerere University School of Public Health
Uganda, Kampala
Makerere University
Uganda, Kampala
Uganda Ministry of Health
Pariyo, George William
Uganda, Kampala
Makerere University School of Public Health
Peterson, Stefan Swartling
Sweden, Stockholm
Karolinska Institutet
Uganda, Kampala
Makerere University School of Public Health
Statistics
Citations: 103
Authors: 6
Affiliations: 5
Identifiers
Doi:
10.1016/j.trstmh.2005.11.004
ISSN:
00359203
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Qualitative
Study Locations
Uganda