Maternal diagnosis and treatment of children's fever in an endemic malaria zone of Uganda: implications for the malaria control programme
A mother's ability to suspect malaria in the presence of fever has important consequences for child survival in malaria-endemic areas. This paper presents results of a clinic-based study of mothers' abilities to suspect malaria in the event of recognizing fever and other physiological and...
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Published in | Acta tropica Vol. 68; no. 1; pp. 53 - 64 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
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Elsevier B.V
14.10.1997
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Abstract | A mother's ability to suspect malaria in the presence of fever has important consequences for child survival in malaria-endemic areas. This paper presents results of a clinic-based study of mothers' abilities to suspect malaria in the event of recognizing fever and other physiological and behavioral changes associated with the disease. The study population consisted of all (439) women or mothers who had accompanied children 5 years and below to the Old Mulago Hospital, Kampala, Uganda over a 10 day period during the malaria season of 1992. The children were those who had fever as a major complaint at the time of the visit or those who had fever in the last 7 days and were visiting the clinic for the first time for the current illness. The children were physically examined and their blood tested for malaria parasites. Mothers' diagnosis was compared with clinical and laboratory diagnosis of malaria. Mothers associated the presence of fever with several types of illness and malaria was often not suspected. Only 40% of the mothers suspected malaria in their children. The mothers were poor at recognizing malaria when, in fact, it was present. The sensitivity of the mothers' diagnosis of malaria was found to be 37%; 63% of malaria cases were misclassified as other conditions. The doctors classified most (92%) of the cases presenting with fever as having malaria, but laboratory tests indicated that only 64% of the children really had malaria. The sensitivity of clinical diagnosis was 98%, but the specificity was only 18%. Ninety percent of the mothers gave some medicines before visiting the health centre; and, of these, 76% gave modern drugs exclusively, including antimalarials, antipyretics, antibiotics and other drugs. Among the modern drugs given to children suspected of having malaria, 50% were antimalarials. The most commonly used antimalarial was chloroquine tablets. Mothers indiscriminately administered antimalarials to children irrespective of the perceived cause of the fever. There is need to educate mothers to suspect malaria first in every case of febrile illness, just like the doctors do, and about the first line drugs for the treatment of malaria. |
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AbstractList | A mother's ability to suspect malaria in the presence of fever has important consequences for child survival in malaria-endemic areas. This paper presents results of a clinic-based study of mothers' abilities to suspect malaria in the event of recognizing fever and other physiological and behavioral changes associated with the disease. The study population consisted of all (439) women or mothers who had accompanied children 5 years and below to the Old Mulago Hospital, Kampala, Uganda over a 10 day period during the malaria season of 1992. The children were those who had fever as a major complaint at the time of the visit or those who had fever in the last 7 days and were visiting the clinic for the first time for the current illness. The children were physically examined and their blood tested for malaria parasites. Mothers' diagnosis was compared with clinical and laboratory diagnosis of malaria. Mothers associated the presence of fever with several types of illness and malaria was often not suspected. Only 40% of the mothers suspected malaria in their children. The mothers were poor at recognizing malaria when, in fact, it was present. The sensitivity of the mothers' diagnosis of malaria was found to be 37%; 63% of malaria cases were misclassified as other conditions. The doctors classified most (92%) of the cases presenting with fever as having malaria, but laboratory tests indicated that only 64% of the children really had malaria. The sensitivity of clinical diagnosis was 98%, but the specificity was only 18%. Ninety percent of the mothers gave some medicines before visiting the health centre; and, of these, 76% gave modern drugs exclusively, including antimalarials, antipyretics, antibiotics and other drugs. Among the modern drugs given to children suspected of having malaria, 50% were antimalarials. The most commonly used antimalarial was chloroquine tablets. Mothers indiscriminately administered antimalarials to children irrespective of the perceived cause of the fever. There is need to educate mothers to suspect malaria first in every case of febrile illness, just like the doctors do, and about the first line drugs for the treatment of malaria. |
Author | Ewbank, Douglas Norman, Sandra Lubanga, Rosalind G.N. Karamagi, Charles |
Author_xml | – sequence: 1 givenname: Rosalind G.N. surname: Lubanga fullname: Lubanga, Rosalind G.N. organization: Clinical Epidemiology Unit, Makerere University, P.O. Box 7423, Kampala, Uganda – sequence: 2 givenname: Sandra surname: Norman fullname: Norman, Sandra organization: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA 19 104, USA – sequence: 3 givenname: Douglas surname: Ewbank fullname: Ewbank, Douglas organization: Population Studies Center, University of Pennsylvania, Philadelphia, PA 19 104, USA – sequence: 4 givenname: Charles surname: Karamagi fullname: Karamagi, Charles organization: Department of Pediatrics/Clinical Epidemiology Unit, Makerere University Medical School, Kampala, Uganda |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/9352002$$D View this record in MEDLINE/PubMed |
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Cites_doi | 10.1002/sim.4780132206 10.2190/EBB8-VX9L-TKQ2-BARJ 10.1016/0035-9203(92)90076-O 10.4269/ajtmh.1995.52.306 10.1146/annurev.pu.08.050187.000451 10.17226/2208 10.1016/0001-706X(94)90020-5 |
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Keywords | Presumptive treatment Uganda Index of suspicion Malaria Sick child Child survival Cross Sectional Analysis Eastern Africa Age Factors Malaria--prevention and control Parents Research Methodology English Speaking Africa Mothers Child Survival Length Of Life Population Characteristics Population Research Report Parasitic Diseases Child Demographic Factors Family Relationships Mortality Africa Youth Survivorship Examinations And Diagnoses Diseases Family Characteristics Treatment Signs And Symptoms Developing Countries Africa South Of The Sahara Family And Household Population Dynamics |
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SubjectTerms | Adolescent Adult Aged Child Child survival Child, Preschool Cross-Sectional Studies Female Fever - diagnosis Fever - therapy Humans Index of suspicion Infant Infant, Newborn Malaria Malaria - diagnosis Malaria - prevention & control Middle Aged Mothers Population Presumptive treatment Sick child Uganda |
Title | Maternal diagnosis and treatment of children's fever in an endemic malaria zone of Uganda: implications for the malaria control programme |
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