1. Community case management of lower chest indrawing pneumonia with oral amoxicillin in children in Kenya.
- Author
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Onono M, Abdi M, Mutai K, Asadhi E, Nyamai R, Okoth P, and Qazi SA
- Subjects
- Child, Preschool, Female, Health Plan Implementation, Humans, Infant, Kenya epidemiology, Male, Pneumonia diagnosis, Pneumonia epidemiology, Amoxicillin therapeutic use, Anti-Bacterial Agents therapeutic use, Community Health Workers statistics & numerical data, Pneumonia drug therapy
- Abstract
Aim: To determine the accuracy and effectiveness of community health workers (CHWs) when compared to trained nurses for management of pneumonia in Kenyan children., Methods: In Homabay County in western Kenya, children 2-59 months of age with lower chest indrawing pneumonia were identified, classified and treated by CHWs with oral amoxicillin (90 mg/kg per day) for five days at home. Trained nurses visited the child within 24 hours to verify diagnosis; and on day 4 and 14 to assess treatment outcomes., Results: CHWs identified 1906 children with lower chest indrawing pneumonia. There was an 88.7% concordance in classification and treatment for lower chest indrawing pneumonia by CHWs compared to nurses. Children with moderate malnutrition (OR 1.68; 95% CI: 1.22-2.30), comorbidities such as diarrhoea or malaria (OR 1.55; 95% CI: 1.32-1.81) or an additional day of delay in care seeking (OR 1.06; 95% CI: 1.02-1.10) were more likely to have an incorrect classification of lower chest indrawing by the CHW. Comorbidity (OR 1.66; 95% CI: 1.12-2.48) and fast breathing (OR 4.66; 95% CI: 1.26-17.27) were significantly associated with treatment failure on day 14., Conclusion: CHWs can correctly manage lower chest indrawing pneumonia even in high-mortality settings, such as western Kenya, in sub-Saharan Africa., (© 2018 World Health Organization; licensed by Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)
- Published
- 2018
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