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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/1464

Title: Delayed care seeking for fatal pnemonia in children aged under five years in Uganda: a case-series study
Authors: Källander, Karin
Hildenwall, Helena
Waiswa, Peter
Galiwango, Edward
Peterson, Stefan
Pariyo, George
Keywords: Pneumonia
Uganda
Care-seeking actions
Malaria
Issue Date: 2008
Publisher: World Health Organization
Citation: Källander, K., Hildenwall, H., Waiswa, P., Galiwango, E., Peterson, S., Pariyo, G.W. (2008). Delayed care seeking for fatal pneumonia in children aged under five years in Uganda: a case-series study. Bulletin of the World Health Organization, 86
Abstract: Objective To review individual case histories of children who had died of pneumonia in rural Uganda and to investigate why these children did not survive. Methods This case-series study was done in the Iganga/Mayuge demographic surveillance site, Uganda, where 67 000 people were visited once every 3 months for population-based data and vital events. Children aged 1–59 months from November 2005 to August 2007 were included. Verbal and social autopsies were done to determine likely cause of death and care-seeking actions. Findings Cause of death was assigned for 164 children, 27% with pneumonia. Of the pneumonia deaths, half occurred in hospital and one-third at home. Median duration of pneumonia illness was 7 days, and median time taken to seek care outside the home was 2 days. Most first received drugs at home: 52% antimalarials and 27% antibiotics. Most were taken for care outside the home, 36% of whom first went to public hospitals. One-third of those reaching the district hospital were referred to the regional hospital, and 19% reportedly improved after hospital treatment. The median treatment cost for a child with fatal pneumonia was US$ 5.8. Conclusion There was mistreatment with antimalarials, delays in seeking care and likely low quality of care for children with fatal pneumonia. To improve access to and quality of care, the feasibility and effect on mortality of training community health workers and drug vendors in pneumonia and malaria management with prepacked drugs should be tested.
URI: http://hdl.handle.net/123456789/1464
ISSN: 0042-9686
Appears in Collections:Research Articles (Health-Sciences)

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