ABSTRACT
BACKGROUND: The Integrated Management of Childhood Illness (IMCI) strategy uses simple clinical signs for the diagnosis and severity evaluation of community-acquired pneumonia (CAP). OBJECTIVE: To describe paediatrician awareness of the IMCI strategy for CAP. DESIGN: A cross-sectional study analysing a descriptive case of severe CAP, presented as part of the Brazilian Board of Paediatrician Evaluation (BBPE) tests. RESULTS: Eighty-six (774/898) per cent of paediatricians followed the IMCI protocol to treat CAP. Although hospitalisation was considered in 90% of the answers, only 35% based this decision on lower chest indrawing. CONCLUSION: The BBPE showed that most physicians are aware of the IMCI recommendations.
Subject(s)
Guideline Adherence , Pneumonia/prevention & control , Practice Guidelines as Topic , Practice Patterns, Physicians' , Adult , Brazil , Clinical Competence , Community-Acquired Infections/diagnosis , Community-Acquired Infections/prevention & control , Community-Acquired Infections/therapy , Cross-Sectional Studies , Delivery of Health Care, Integrated , Female , Humans , Infant , Male , Pediatrics , Pneumonia/diagnosis , Pneumonia/therapyABSTRACT
In a case-control study to evaluate a systematic scoring system for diagnosing pulmonary tuberculosis (PTB) in children, cases had gastric lavage cultures positive for Mycobacterium tuberculosis and recovered after anti-tuberculosis treatment, while controls had negative cultures and recovered with non-anti-tuberculosis treatment. Radiological aspect (OR = 25.39), contact with a tuberculous adult (OR = 10.67) and tuberculin skin test > or = 10 mm (OR = 8.23) were associated with PTB diagnosis. The sensitivity of the score ranged from 58% to 89% and the specificity from 98% to 86%, with cut-offs of respectively > or = 40 or > or = 30. The scoring system may be a useful diagnostic method in areas with a high prevalence of TB.
