ABSTRACT
This audit of hospital care of acute wheeze and asthma aimed to assess the degree of adherence of the acute care of the asthma patients to the published international guidelines. Information was collected in six key areas: patient demographics; initial asthma severity assessment; in-hospital treatment; asthma prophylaxis; asthma education and emergency planning; and follow-up arrangements. The area of initial asthma severity assessment showed defciencies in the clinical measures currently used to verify case severity. In- hospital treatment on the other hand was consistent with recommendations in the use of the inhaled ß-2 agonist salbutamol as bronchodilator, the discrete use of aminophylline and the small number of patients ordered chest X-ray. However, the treatment was incoherent with recommendations in the delivery method used for inhaled bronchodilator in relation to the age group of treated patients, absence of ipratropium bromide as a bronchodilator in the management and the large use of antibiotics. Assessment of the areas of asthma prophylaxis, asthma education and emergency- planning and follow-up arrangements illustrated that little efforts were made to assure safe discharge, although these measures have been shown to reduce morbidity after the exacerbation and reduce relapse rates and signifcantly reduce hospitalizations, unscheduled acute visits, missed work days, as well as improving quality of life. This audit emphasizes the need for the adoption of a management protocol for acute asthma care in the emergency department based on published international guidelines and the assurance of its implementation, monitoring and evaluation using the right tools to improve patient care.
ABSTRACT
INTRODUCTION: Home care of under-five children is one of the most important interventions in the control of diarrheal diseases. It has a significant impact in reducing childhood mortality and morbidity. OBJECTIVE: This study was conducted to evaluate the effect of health education on home care of under- five children with diarrheal disease. MATERIALS AND METHODS: This is a quasi- experimental study, held in Al Maki neighborhood, which is located in Greater Wad Medani locality, Gezira State, Central Sudan. The study targeted a random sample of 118 mothers who have at least one child under- five years of age with diarrhea needing home management. The study was conducted in three phases. Phase one was a base line survey for the mothers. Intervention phase including different health education approaches, home visits, group sessions and distribution of mother cards through community volunteers and researchers. Post intervention survey using the same pre-intervention questionnaire, and observation of mothers managing their children. RESULTS: Results showed that knowledge of mothers about definition of diarrhea, its danger, when to seek medical help and the three rules of home management which was found to be 35, 28, 13 and 29% improved significantly after intervention to 91, 94, 92 and 93% respectively with a very high significant level. RECOMMENDATIONS: We recommended that volunteers are effective health education provider especially on household based intervention. Health services should support the community based interventions to reinforce the knowledge and practices of mother towards the sick children.
ABSTRACT
AIM: This study aimed to determine the level of infant and under-five mortality rates and to examine the effect of socioeconomic, demographic and environmental factors on the health status of the children under five years. METHODS: The data for this study were collected by means of a questionnaire addressed to women in Wad-Medani, Sudan. Three hundred women in the reproductive age (15-49) years were chosen randomly for this study. The data were analyzed statistically using the Statistical Package for Social Sciences (SPSS). Frequency distributions and a statistical test based on Chi-square for independence was conducted. RESULTS: Infant mortality rate was 77 per 100 and child mortality rate was 67 per 100. The results revealed that immunization, child order, child birth weight, birth interval and contraceptive use had a significant influence on the mortality of children under the age of five. The mother's level of education is highly significant on the mortality of children under five years old. CONCLUSIONS: The Ministry of Health should give greater attention to improving immunization services and concentrate on health education campaigns for mothers and for the community.
ABSTRACT
INTRODUCTION: Cancers form one of the major causes of death in children between the ages of one and 15 years. They differ markedly from adult cancers in their nature, distribution and prognosis. The patterns of childhood cancers in America and Europe are almost the same, with leukemia and central nervous system tumors accounting for over one-half of the new cases. In contrast, lymphoma is the most common prevailing cancer of this age group in Africa. OBJECTIVE: The objective of this study is to determine the patterns of childhood cancers in Gezira State, Central Sudan. It is a retrospective study using hospital records. All children with cancer, aged 1 - 15 years diagnosed by means of histological or cytological examination admitted to the Institute of Nuclear Medicine, Molecular Biology and Oncology from May 1999 - December 2004 were included in the study. RESULTS: The results showed a pattern of childhood lymphoma as the most common cancer (42.8%) followed by acute lymphoblastic leukemia (19.8%) and kidney tumor (12.8%). The prevalence of cancer was found to be higher among boys (64.7%) than girls (35.3%) with a rate of 1.8:1. Most of the children admitted with cancer were from rural areas (66.1%) compared to (33.9%) from urban areas. CONCLUSION: Lymphoma, acute lymphoblastic leukemia and bone tumor commonly occurred in children above 5 years in contradistinction to kidney tumor and retinoblastoma which was prevalent in children less than 5 years of age.
