Clinical management of children with fever: a cross-sectional study of quality of care in rural Zambia

Objective:To evaluate current practices and standards of evaluation and treatment of childhood febrile illness in Southern Province, Zambia.Methods:From November to December 2013, we conducted a cross-sectional survey of facilities and health workers and we observed the health workers' interactions with febrile children and their caregivers. The facility survey recorded level of staffing, health services provided by the facility, availability and adequacy of medical equipment, availability of basic drugs and supplies and availability of treatment charts and guidelines. The health worker survey assessed respondents' training, length of service, access to national guidelines and job aids for managing illnesses, and their practice and knowledge on management of neonatal and child illnesses. We also conducted exit interviews with caregivers to collect information on demographic characteristics, chief complaints, counselling and drug dispensing practices.Findings:This study included 24 health facilities, 53 health workers and 161 children presenting with fever. Facilities were insufficiently staffed, stocked and equipped to adequately manage childhood fever. Children most commonly presented with upper respiratory tract infections (46%; 69), diarrhoea (31%; 27) and malaria (10%; 16). Health workers insufficiently evaluated children for danger signs, and less than half (47%; 9/19) of children with pneumonia received appropriate antibiotic treatment. Only 57% (92/161) were tested for malaria using either rapid diagnostic tests or microscopy.Conclusion:Various health system challenges resulted in a substantial proportion of children receiving insufficient management and treatment of febrile illness. Interventions are needed including strengthening the availability of commodities and improving diagnosis and treatment of febrile illness

Socioeconomic Correlates and the Choice of Treatment for Childhood Fever in Ghana

The study investigated the effect of household socioeconomic factors on the choice of treatment for childhood fever among children under age five in Ghana. Data from the 2008 Ghana Demographic and Health survey was used employing the multinomial probit model. Three treatment choices were considered: Government facility; Private facility and traditional/self-medication. The results suggest that the treatment of childhood fever is related to household wealth; health insurance status and residence. Government health facilities are mostly used by household's with higher wealth and household's with health insurance. Rural households are more likely to use traditional/self-medication; except those with health insurance who use government facilities. The age of the mother and birth order of the child were also found to influence the choice of treatment facility for childhood fever

Evaluation of the analgesic activity of the methanolic stem bark extract of dialium guineense (wild)

Background: Dialium guineense is a medicinal plant used by some communities of Enugu-Ezike in Enugu State; Nigeria for treatment of fever; headache and other diverse ailments. Objectives: The present study evaluated the analgesic activity of the methanolic stem bark extract of the plant. Method: Acetic acid-induced abdominal constriction or writhing; tail immersion and hot plate analgesic models in albino Wistar mice were used for the study. Three test doses (250; 500; 1000 mg/kg body weight) of the extract were administered orally by gastric gavage. The activity was compared with a standard reference drug; acetylsalicylic acid (aspirin) (400 mg/kg) and negative control. The results were analysed by SPSS version 17 using ANOVA and Post Hoc Duncan. Result: In the acetic acid-induced writhing reflex model; D. guineense extract and the reference drug significantly (P =0.014 - 0.002) decreased the mean total number of abdominal constriction in the mice in a dose dependent fashion. The percentage inhibition of the abdominal constriction reflex was increased dose dependently from 0in the negative control group to 71at the highest dose of the extract (1000mg/kg). In the tail immersion model the extract at the dose of 1000 mg/kg significantly (P = 0. 048) increased the pain reaction time (PRT) while in hot plate model the extract and drug also significantly (P = 0.048 - 0.05) increased the mean PRT at the doses of 500 and 1000 mg/kg. The dose of 250 mg/kg showed no analgesic activity in tail immersion and hot plate models. Conclusion: Dialium guineense demonstrated significant analgesic activity that may be mediated through peripheral pain mechanism

L'association paracetamol+ibuprofene est-elle preferable au paracetamol seul ou a l'ibuprofene seul pour le traitement de la fievre chez les enfants?

Il apparait de plus en plus sur le marche burkinabe des medicaments; des associations de substances d'indication similaire; et dont l'interet therapeutique reste a demontrer. Ces associations contribuent-elles a un usage rationnel des medicaments? Faut-il continuer a homologuer ces associations ? Nous presentons ici les resultats d'une etude sur l'association paracetamol+ibuprofene dans la fievre chez les enfants

Douleur ou fievre chez les enfants : preferer le paracetamol

Dans la plupart des cas ; le paracetamol est efficace pour lutter contre la douleur et la fievre chez les enfants .Il est plus sure que les anti-inflammatoires ( y compris l'Ibuprofene et l'aspirine)