Care-seeking behavior for fever in children under five years in an 25 urban area in eastern Sudan

Early diagnosis and prompt treatment are the basic elements of malaria control. The mother's perceptions about the cause of the fever, duration of sickness, accessibility and the anticipated cost of treatment, frequent use of traditional medicine, and judgement of the severity of the fever are the most important determinants for effective treatment of fever in children. This cross-sectional study was conducted in Kassala city, in Eastern Sudan to investigate the caregivers' care-seeking behaviour related to fever among children < 5 years. Data was collected by trained social workers using a structured questionnaire and was analysed by means of SPSS. Three-hundred fifty housewives were interviewed. The majority [85.7%] had had at least basic education and 244 [69.7%] were full-time housewives. A total of 237 [67.7%] mothers were found to have adequate knowledge about malaria. Malaria was perceived by only 143 [40.9%] of the respondents as a cause of low grade fever and this percentage was almost doubled in the case of high fever. There were similar findings with respect to the selection of treatment sources and the use of antimalarial drugs. High fever urged 319 [91.1%] to seek advice from health workers and 281 [80.3%] to take drugs other than chloroquine. The intensity of fever [low/ high] governed the respondent's perceived causes of fever, decision about available treatment options and the type of antimalarial drugs they used. Health education programmes should focus on the importance of seeking early advice, compliance with prescribed treatment and awareness and handling of danger signs before presenting at health facility

Delayed diagnosis of foreign body aspiration in children

Foreign body aspiration in children is common and usually presents with an initial episode of choking with subsequent respiratory symptoms. There may be cough, wheeze, or strider, with decreased or abnormal breath sounds on examination. However, it can mimic other illnesses and cause difficulty in diagnosis. Radiological investigations may help to confirm aspiration but should not be used to exclude it. This case is a presentation of foreign body aspiration with a delay in diagnosis and misdiagnosed as bronchial asthma. It is believed that delay could have been avoided with a more careful approach to the history and more appropriate use of investigations. This case also demonstrates the use of CT scan with reconstruction in diagnosis of foreign body