The integrated management of childhood illness approach (IMCI) is currently being implemented by a number of countries worldwide.
This is the second report from a study in western Uganda comparing the assessment and classification of disease by medical assistants using the IMCI algorithm with that of hospital-based general medical officers, who used their clinical judgement to assess and provide treatment.
Treatment prescribed by the hospital medical officers was compared to that indicated by IMCI disease classifications.
The study population comprised 1226 children aged 2--59 months.
Medical assistants had some difficulty in completing the IMCI assessment, leading to incorrect classification of findings in 138 of 1086 completed forms (13%). If their classifications had been used to decide on hospital referral, 37 children who met IMCI criteria for referral would have been sent home.
Consultations took on average 7.2 min, longer than usual for several African countries.
Use of the IMCI guidelines would have referred 16.2% of children to hospital, compared with 22% referred by the medical officers.
Use of IMCI could have reduced the cost of medication to US$0.17 per child compared to the treatment cost of US$0.82 as prescribed by medical officers.
Medical officers prescribed both a greater number and a greater variety of drugs than indicated by the IMCI algorithm. (...)
Mots-clés Pascal : Soin intégré, Algorithme, Diagnostic, Traitement, Maladie, Etude statistique, Enfant, Homme, Ouganda, Afrique
Mots-clés Pascal anglais : Managed care, Algorithm, Diagnosis, Treatment, Disease, Statistical study, Child, Human, Uganda, Africa
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0463295
Code Inist : 002B30A03B. Création : 19/02/1999.