1 A Preliminary Report Ijeoma Ejigiri, GE/NMF Scholar Supervisor: Dr. Data Santorino, Assistant Lecturer Department of Pediatrics and Child Health Mbarara University of Science and Technology, Uganda
2 Malaria is the leading cause of morbidity and mortality of children in Uganda, approximately 8-13 million episodes per year. Plasmodium falciparum, the most deadly of the malaria parasites, is responsible for the majority of the cases. In 2009, the prevalence of malaria parasitemia, based on light microscopy, was approximately 30-50% of children aged 6-59 months old
3 A study by Nuwaha et al directly examined people s perception of malaria in Mbarara, through the use of focus groups and interviews (2002) 95% of participants reported that mosquitoes were responsible for transmission of malaria Prevention strategies 46% of participants reported use of bed nets 28% reported keeping surroundings clean, environmental sanitation only 5% percent reported immediate treatment of fever
4 Several studies performed in sub-saharan Africa have demonstrated a correlation between fever and P.falciparum parasitemia. A study conducted in Mali, 33.6% of fevers in children were attributable to malaria (Dicko et al 2005). In southern Ghana the fraction of fevers attributable to malaria was 44% in children up to two years of age (McGuinness et al 1998). Several studies performed in Uganda, Ghana, and Nigeria have shown that fever is one of the most recognized signs of malaria within the community (Agu et al 2005, Asante et al 2010, and Tumwesigire et al 2002).
5 Although malaria remains the leading cause of fever in children in sub-saharan Africa, there are many other common causes of fever in children The Mbarara Hospital Annual Performance report, listed pneumonia and septicemia among the top five causes of morbidity and mortality in children. Other common pediatric illnesses presenting with fever include viral and bacterial infections causing gastroenteritis, diarrhea or meningitis. According to the 2006 Uganda Demographic and Health Survey, 41% of Ugandan children had fever in the two weeks preceding the survey.
6 Given the large burden of fever in pediatrics, we propose a study to examine a parent s initial response to a child s fever. Delaying the seeking of treatment for malaria can be associated with worse outcomes. It is important to immediately treat non-malarial causes of fever that can be life threatening such as diarrhea or bacterial meningitis. In the effort to achieve malaria control and improve childhood morbidity and mortality due to common childhood illnesses, a first step is assessing parental awareness and response to fever.
7 To determine the initial response to fever among parents presenting with febrile children to Toto ward, Mbarara Regional Referral Hospital (MRRH). To identify factors that determine a parent s initial response to fever in children presenting to the pediatric ward of MRRH.
8 Study Location The study was conducted in the Pediatric ward of Mbarara regional referral hospital. Study subjects Interviewees were the parents or the primary care givers of sick children aged 0 12 years presenting with fever as one of the chief complaints. Study design This is a cross sectional study. Sampling Method We used consecutive sampling to enroll participants in the study.
9 Inclusion criteria Parents or primary care givers of children who present with a chief complaint of fever were included in the study. Exclusion criteria Neonates or children with fever referred to the pediatric ward from the Obstetrics and Gynecology department or any other department of MRRH, were not included.
10 The sample size was calculated using the Kish and Leslie formula: N= Z 2 x (P) x (1-P)/C 2 N=sample size, Z = 1.96 for 95% CI, P= estimated prevalence of fever, C = margin of error (5%). For the purpose of this study, we used the prevalence of fever in children in Uganda as 41% as reported in the Uganda Demographic Health Survey (UDHS, 2006). With a margin of error of 5% and 95% confidence intervals, a sample size of 372 respondents was calculated. Within the two week time period for data collection, 74 respondents were interviewed
11 Data collection and instrument A questionnaire with pre-coded multiple choice options was administered to parents of sick children who present with a chief complaint of fever. The questionnaire included questions on demographics of the parents and children, and also assessed initial parental decisions in response to their child s fever. Factors that may influence parental initial response to fever were also assessed.
12 Data analysis: The Data was analyzed with use of Microsoft Excel Quality control The questionnaire was translated into the local language of Runyankole to decrease variability in question translation. The questionnaire was administered with the use of an interpreter to help decrease the limitations of the language barrier.
13 Child Demographics Average age of the child 19.7 months Minimum age 1week Maximum age 9 years Males n=45 Sex of the child Males 60.8% 39% Females n=45
14 Parent Demographics Married n=61 82% Marital Status 1.3% Widowed n=61 Type of Housing 37% 37% Permanent n=29 6% 9.4% Seperated n=7 62% Single n=6 Semi-permanent n=47
15 Occupation Father Peasant n = 24 (33%) Business n= 20 (28%) Mother Peasant n= 51 (65%) Business n= 8 (10.8)%) Primary N=35 Secondary N=19 Education: Father 53% 29% 6.1% 3% 7.6% None N=4 University N=2 College N=5 Primary N=43 Education: Mother 58% 23% 13.6% None N=23 4% College N=3 Secondary N=10
16 70 Patient Districts 60 N=43 % of respondants N=9 N=4 N=3 N=3 Mbarara Isingiro Kiruhura Sheema Ibanda Ntungamo Other District N=2 N=8 Other Districts n=8 Kabale, Lakai, Kamwenge, Kisoro, Lwengo, Kasese, Rukungiri, Bushenyi
17 Transportation Method Boda-boda N=32 Taxi N=38 43% 51% On Foot 2.7% N=2 2.7% Ambulance N=2 Average Distance from Hospital Minimum distance Maximum distance Average Time to Hospital Minimum time Maximum time Average Transportation cost Minimum cost Maximum cost 33.6 km (SD 36.2) 1.5 km 122km 1.6 hours (SD 1.9) 5 minutes 12 hours Ush 6,168 (SD 7811) Ush 0 Ush 60,000
18 Symptom N % Average duration in days (SD) Fever (7.9) Cough (17.4) Difficulty in breathing (9.9) Convulsions (2.2) Diarrhea (6.3) Vomiting (5.5) Body Swelling (11) Dark Urine (4.9) Loss of consciousness (4.8) Poor breast feeding (14.3) Yellowing of eyes (1.7) Other (constipation, epistaxsis, mouth ulcers,pallor) 12 16
19 Drugs Administered N % 50 Paracetamol N=33 ACT/Coartem Quinine Gentamicin Ampicillian % of respondents N=13 N=14 Amoxil Septrin Herbs Cough syrup Penicillin clinic hospital drug shop N=8 N=4 N=2 Leftover drugs Clinic Hospital Drug shop leftover drugs Herbs Other-Health Center Parental Choices Herbs Other Health Center Flagyl 3 4 Oral rehydration solution Unidentified syrup, tablets, or injections Unknown Nothing administered Other: 15 20
20 70 After how long did you take action from the onset of fever? 50 When did you first take your child to a health care worker? 60 N=45 40 N=30 50 % of respondents N=11 N=4 N=14 % of respondents N=13 N=9 N=22 0 < 24hrs <2 days < 3 days > 3 days 0 < 24 hrs < 2 days < 3 days > 3 days
21 Why did you choose to come to this hospital? 70 N= % of respondants N= 21 N= N= 4 N= 2 Belief in RxGood Experience Proximity Severity of illness Referral Reasons
22 100 % of respondents N= 17 Parental quotes: I wanted to first reduce the fever with paracetamol Another respondent was told by relatives that her child had a traditional illness. N=1 N= 2 N= 2 0 Not sick enough Didn't trust Rx No transport Other Reasons
23 % of children Admission Dx Final Dx 11 9 Other Diagnoses: Heart failure Tumor UTI Renal disease Leukemia TB Cellulitis Salmonellosis Pneumothorax 0 Malaria Pneumonia GE PEM Meningitis Anemia Neonatal Sepsis Septicemia Diagnoses
24 The majority of the study participants were poor peasants living in semi-permanent housing with little formal education. The study population reflects the typical rural population found of Uganda. The most favored parental response to fever was to utilize a nearby clinic. Many of the respondents also chose to utilize a hospital or health center. Similar results were observed in studies conducted in Kabale, Uganda and Ebony State, Nigeria (Agu et al 2005 and Tumwesigirie et al 2002).
25 Although, 60% of the respondents reported taking action in response to the onset of their child s fever within 24 hours, there was a delay in seeking out health care workers. Only 40% of the respondents reported seeing a healthcare worker within 24 hours of the onset of fever. Almost 30% of the respondents reported waiting more than three days to seek out a healthcare worker. This delay in seeking out a healthcare worker, can be attributed to the fact that the majority of the respondents who did not go to the hospital or clinic first reported that they didn t feel the child was sick enough.
26 Malaria was the most common diagnosis ascribed to the febrile children on admission. The second most common diagnosis on admission was pneumonia. However, when examining the final diagnoses, we found that there were more children diagnosed with pneumonia than malaria. It must be noted that many of the children were tested for malaria with the use of a single blood smear. However, a low parasitemia can be missed with only one blood smear. With the advent of rapid diagnostic tests (RDT), which can be more sensitive than blood smears, there can be improved diagnosis of malaria
27 The use of a hospital sample may not be a true representation of the general population. It would be ideal to randomly sample the community and interview parents whose children had fever. Due to time constraints, I was not able to obtain the sample size before departing. My supervisor hopes to ensure completion of data collection even after my departure. Upon completion of the data collection it will be interesting to look for statistically significant associations between variables, such as correlations between education level, occupation, duration of symptoms and the response to fever.
28 The WHO Recommendations Children under age 5, living in highly malaria endemic regions, should be diagnosed clinically and treated presumptively with antimalarials. ACTs are the first line recommended treatment against P.falciparum. Use of parasitological diagnosis is recommended for children over age 5 that develop fever. Given these recommendations, parents should be counseled and educated to seek out the help of a health care worker as soon as possible when their child becomes febrile to help aid in the diagnosis and treatment of malaria. In addition, a health care workers can help to identify potentially life-threatening non-malarial causes of fever such as pneumonia and gastroenteritis, which are also extremely common in this pediatric population.
29 Dr. Data Santorino Dr. Stephen Ttendo Manfred Amanya GE/NMF Program and Faculty All Faculty and Staff of Toto Ward All Study participants
30 Agu et al., Childhood malaria: mothers perception and treatment-seeking behaviour in a community in Ebonyi State, South East Nigeria. Journal of Community Medicine and Primary Health Care 2005, 17: Asante et al., Community perceptions of malaria and malaria treatment behaviour in a rural district of Ghana: implications for artemisinin combination therapy BMC Public Health 2010, 10:409 Dicko A. et al. Season, fever prevalence and pyogenic threshold for malaria disease definition in an endemic area of Mali. (2005) Tropical Medicine and International Health. Vol 10, McGuinness D, Koram K, Bennett S, Wagner G, Nkrumah F & Riley E (1998) Clinical case definitions for malaria: clinical malaria associated with very low parasite densities in African infants. Transactions of the Royal Society of Tropical Medicine and Hygiene 92, Nuwaha R. People s Perception of malaria in Mbarara, Uganda. Tropical Medicine and International Health 2002, 7: Tumwesigirie S. et al., Health seeking behavior by families of children suspected to have malaria in Kabale:Uganda. Afri Health Sci December; 2(3):
Introduction The Ministry of Health declared an outbreak of Marburg in Kabale district on October 19 th 2012 after receiving laboratory results from the Uganda Virus Research Institute (UVRI) confirming
Nigerian National Antimalaria Treatment guidelines Pre Purpose: To provide guidelines for the treatment of malaria in Pregnant women in Nigeria Pregnant women Malaria: An infectious disease caused by plasmodium.
World Health Organization Integrated Management of Childhood Illness (IMCI) Sarah Ashley, MD 14 October 2015 Goals for today Identify key causes of childhood mortality Explain the meaning and purpose of
MODULE-6 INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESS Identify Treatment for the Sick Child CONTENTS INTRODUCTION... 1 1.0 DETERMINE IF URGENT REFERRAL IS NEEDED... 1 2.0 IDENTIFY TREATMENTS
Community Case Management of Severe Pneumonia with Oral Amoxicillin in Children 2-59 months of age in rural Pakistan; a cluster randomized controlled trial Study Coordinator Dr Sajid Bashir Soofi Assistant
Malaria: A Major Cause of Anemia Among Under 5 Children on Hospital Bed in State Specialist Hospital, Ondo, Ondo State, Nigeria. Fowowe A. A State Specialist Hospital, Ondo, Ondo State. Nigeria. Correspondence:
REQUEST FOR PROPOSALS FOR CONDUCTING COMPREHENSIVE DATA QUALITY ASSESSMENT AND AUDIT AMONG HEALTH FACILITIES SUPPORTED BY EGPAF UGANDA The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) seeks to end
1 Global malaria Key facts In 2010, malaria caused an estimated 660 000 deaths (with an uncertainty range of 490 000 to 836 000), mostly among African children. Malaria is preventable and curable. Increased
END-MALARIA BLUE RIBBON CAMPAIGN STUDENTS LEADERS AGAINST MALARIA (SLAM) WORKSHOP Malaria Prevention Basics Produce by SOCIETY FOR YOUTH AWARENESS AND HEALTH DEVELOPMENT (SYAHD) No 9 B Wudil/Sabo Bakin
RTS,S (Mosquirix ) Frequently Asked Questions (FAQs) 1. What is RTS,S? RTS,S is the first malaria vaccine candidate to receive a positive scientific opinion from the European Medicines Agency (EMA), whose
Guidelines for the Treatment of Malaria (3 rd edition 2015) Joint UNICEF, UNFPA & WHO Meeting with Manufacturers & Suppliers Copenhagen, Denmark, 23 Nov. 2015 Dr. Peter OLUMESE, Global Malaria Programme
Health seeking behavior by families of children suspected to have malaria in Kabale: Uganda *Sam Tumwesigire 1 and Sharon Watson 2 1 Kabale Regional Hospital, P.O. Box 7, Kabale, Uganda 2 Development Studies
MMV Stakeholders Meeting, New Dheli, 7-8 November, 2012 Improving Access to treatment in Myanmar Dr. Thar Tun Kyaw Deputy Director ( Malaria ) Programme Manager National Malaria Control Programme Ministry
Medication Guide LARIAM (LAH-ree-am) (mefloquine hydrochloride) Tablets to Prevent Malaria This Medication Guide is intended only for travelers who are taking Lariam to prevent malaria. The information
Malaria IPC GUIDE What is Malaria? What is Malaria? What is Malaria? Malaria is a life-threatening parasitic disease How is Malaria Caused? Malaria is caused by plasmodium falciparum parasite trasnsmited
Malaria in PNG Charles W. Lepani PNG High Commissioner 28 October 2006 Conference of Rotary International District 9710 Batemans Bay, NSW Papua New Guinea Impact of malaria Largest disease burden in PNG
B ARTESUNATE FOR THE TREATMENT OF SEVERE MALARIA 1. Summary statement of the proposed changes Severe malaria is a medical emergency that requires prompt diagnosis and treatment. The mortality of untreated
UNICEF-NYHQ26-572-Noorani Invest in the Future: Defeat Malaria World Malaria Day 213 Focus on Africa Statistics and Monitoring Section Division of Policy and Strategy World Malaria Day 213 Invest in the
Clinical Management of Cholera CDC Centers for Disease Control and Prevention Cholera / Clinical Management / 1 Cholera Most infections are mild Deaths are due to dehydration Rehydrate patients rapidly,
Niger 2013 Tackling the deadly combination of malaria and malnutrition There are six of us in the family. We do not have enough food for everyone because we have not been able to harvest our crops. The
CLINICAL CASE STUDY SERIES Malaria Treatment: Better than the Standard of Care In 2008, more than 100 countries were endemic for malaria, almost half of which were in the African region as defined by the
Delay among women reporting symptoms of Breast cancer P B V R Kumari 1, C S E Goonewardena 2 Abstract Objective To describe factors related to timing of first contact with an allopathic medical practitioner,
Identification and Understanding of Preterm Birth An assessment of the quality of neonatal care at Kintampo Municipal Hospital Joanna Parga, MS IV The Mount Sinai School of Medicine 2011 GE/NMF Scholar
Vaccine Benefits: Why Get Vaccinated? Multi Vaccine Your children s first vaccines protect them from 8 serious diseases, caused by viruses and bacteria. These diseases have injured and killed many children
The rate of failure to thrive among children aged 2 months - 5 years in Kanaan sub-district / Diyala province Mehdi SH. Al-Zuheiry (M.B.Ch.B., F.I.C.M.S.Ped.) College of Medicine-Diyala University Background:
Step 5: Choose Evaluation Design and Methods Tool: Design and Methods Example Tables Training Evaluation Framework and Tools (TEFT) Introduction: At this stage, you have reviewed the Training Evaluation
46 PRODUCT MONOGRAPH MEFLOQUINE Mefloquine Hydrochloride Tablets 250 mg (as base) THERAPEUTIC CLASSIFICATION Antimalarial Agent INFORMATION FOR THE PATIENT MEFLOQUINE Tablets to Prevent Malaria This information
TECHNICAL UPDATES: The document lists the recommended changes in national IMCI treatment protocols. The summarized recommendations are listed first. The evidence and the implications for practice are listed
Enhancing adherence to ACTs purchased from drug shops: results from four intervention studies Mon 7 Oct, 17:00 18:30 Chairs: Catherine Goodman and Kathleen Maloney OVERVIEW Patient adherence, the extent
Royal Manchester Children s Hospital Methotrexate Information For Parents and Young People What is Methotrexate and how does it work? Whenever there is an injury, infection or irritation, the body s immune
TUBERCULOSIS (TB) SCREENING GUIDELINES FOR RESIDENTIAL FACILITIES AND DRUG Tx CENTERS Tuberculosis Control Program Health and Human Services Agency San Diego County INTRODUCTION Reducing TB disease requires
Accessing antiretroviral therapy (ART) is a matter of life and death for HIV-infected children. Without ART, half of children born with HIV die by the age of two years, and 80 percent die by the age of
Promoting Early Cancer Presentation Group Nature and duration of symptoms of cancers of the lung: report of a study of nature and duration of symptoms Fiona Warburton, Lindsay Forbes November 2013 1 Introduction
INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI) KNOWLEDGE POST-TEST With Answer Key Trainee Name: Code: Date: Training: Group 1 Group 2 IMCI KNOWLEDGE POST-TEST 1) What is the dose and schedule of amoxicillin
Request for proposals for conducting baseline assessment for the USAID Regional Health Integration to Enhance Services Project in South Western Uganda (USAID RHITES SW) Background The goal of USAID Regional
Supported by Australian Aid, AusAID Contents Unit scenario 1 Papua New Guinea: a country profile 2-4 HIV and AIDS 5-6 Responding to HIV and AIDS in PNG 7-8 Nutrition, child and maternal health 9-10 Responding
WHO Informal Consultation on fever management in peripheral health care settings: a global review of evidence and practice Geneva, 22-24 January 2013 Briefing paper for the MPAC by V. D Acremont and A.
Fact sheet Key facts is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected mosquitoes. In 2012, malaria caused an estimated 18 000 deaths in the
Patient History Questionnaire Comprehensive Breast Care Center Patient Name of birth Age Occupation Today s Height Weight Primary Care Physician: OB/ GYN: Referring Physician: Who else may we send a medical
Child Malnutrition in Africa At least 1 in 3 children under-five in Africa were stunted in Approaches to prevent stunting Interventions should focus on the critical 1, days window including pregnancy and
Hepatitis C What is Hepatitis C? Hepatitis C is a liver disease caused by infection with the hepatitis C virus. Who gets hepatitis C? Anyone can get hepatitis C, but those at greatest risk are: Individuals
Improving mental health care for young adults in Badakshan Province of Afghanistan using ehealth Survey Questionnaire for Facility based Health Providers To be conducted with Health Providers in both Intervention
T e c h n i c a l S e m i n a r s Other Causes of Fever Febrile Illness Causes Fever After Seven Days Referral Relapsing Fever - Borreliosis Overview JHR Adaptation Sore Throat Overview Prevention Management
IS RELIGIOUS AFFILIATION INFLUENCING PREVENTION AND TREATMENT OF MALARIA AMONG CHILDREN IN UGANDA? AUTHORS Ndugga Patricia AFFILIATION Department of Population Studies, Makerere University, Uganda EXTENDED
Can Good Products Drive Out Bad? Evidence from Local Markets for (Fake?) Antimalarial Medicine in Uganda IGC Growth Week, Sep 25 2012 Martina Björkman-Nyqvist, Stockholm School of Economics Jakob Svensson,
Journal of Community Medicine and Primary Health Care. June 2005; 17(1): 45-50 Childhood malaria: mothers' perception and treatmentseeking behaviour in a community in Ebonyi State, South East Nigeria AP
Malaria Why should I worry about malaria? Globally, malaria is one of the six major causes of deaths from communicable diseases. 90% of world s approximately 600 000 annual malaria deaths occur in Africa.
1 ANEMIA DATA IN EVALUATING IMPACT OF MALARIA INTERVENTIONS: A MULTI COUNTRY ANALYSIS Anemia Task Force October 18, 2013 2 Outline How does PMI assess impact of malaria control? Severe anemia as an indicator
Science Journal of Public Health 2013; 1(2): 102-106 Published online June 10, 2013 (http://www.sciencepublishinggroup.com/j/sjph) doi: 10.11648/j.sjph.20130102.19 Morbidity and associated factors of diarrheal
GLOBAL HEALTH ESSENTIAL CORE COMPETENCIES All medical graduates should understand the major factors that influence the health of individuals and populations worldwide. They should have a basic understanding
A study on patients knowledge of Tuberculosis and timeline to treatment Puvaneswari Subramaniam,MPH* *Jabatan Kesihatan Negeri Perak,V Paranthaman** **, Family Medicine Specialist, KK Jelapang,, Paul Eruthiasamy*,
James Paget University Hospitals NHS Foundation Trust Malaria Patient Information What is malaria? Malaria is a serious and potentially life threatening illness caused by infection with the protozoan parasite,
Burden of Pneumonia in Children Objectives 1. Provide an overview of pneumonia: symptoms and diagnosis 2. Characterize the burden of pneumonia morbidity and mortality globally and in South Asia 3. Characterize
International Journal of Sciences: Basic and Applied Research (IJSBAR) ISSN 2307-4531 (Print & Online) http://gssrr.org/index.php?journal=journalofbasicandapplied ---------------------------------------------------------------------------------------------------------------------------
Malaria diagnosis WHO Guidelines and their implementation Optimizing control of infectious diseases in resource poor countries: Malaria Diagnosis, Fever home-based-management and New tools European Commission
Page 1 EPIDEMIOLOGICAL SURVEILLANCE REPORT Malaria in Greece, 2015, up to 26/08/2015 Introduction Malaria is a parasitic infection, transmitted through the bite of the infected female Anopheles mosquito.
Seroprevalence and risk factors of Lassa fever infection in Nasarawa State, Nigeria 2013 Muhammad Shakir Balogun COHORT 3 Nigeria-FELTP Supervisors: Dr. AT Olayinka, Dr. AI Mamman Outline Background Methodology
Malaria Fact-file Malaria Fact - File malaria should not be viewed as a given part of life rather it is a preventable and curable disease that can be eliminated. Malaria Facts Many of those who test positive
The Right to Health in Uganda Stakeholder Report on Uganda - Submission by World Vision Uganda For Universal Periodic Review, Twelfth Cycle, November-December 2011 1 Introduction 1.1 The context Uganda
Department of Epidemiological Surveillance and Intervention EPIDEMIOLOGICAL DATA FOR MALARIA IN GREECE (MANDATORY NOTIFICATION SYSTEM) Key Points The notification rate of malaria in Greece shows an increasing
answer key 1 Modes of Transmission Part 1. Basic Framework of Infectious Diseases The table below organizes the basic information of some of the diseases introduced in the reading. For each disease, identify
Updates: WHO Guidelines for the Treatment of Malaria 4 th RBM Case Management Working Group (CMWG) Meeting Geneva, Switzerland 6-7 July, 2010 Dr. Peter OLUMESE, Global Malaria Programme WHO, Geneva, Switzerland.
The knowledge and attitude towards childhood immunization among mothers attending antenatal clinic in Lagos University Teaching Hospital, Nigeria O. AWODELE 1*, I.A. OREAGBA 1, A. AKINYEDE 1, D.F. AWODELE
Malaria control in schools in Mali: Results from a Cluster Randomized Control Trial in Sikasso Region, Mali Malaria in school age children: Why is it important? Children under the age of five years and
Yes No If yes, was Eosinophilia present? Yes No Results pending If yes, was further evaluation done? Yes No ( one) Yes No If why not? Done Results Pending Not done Negative Positive; treated: yes no Indeterminate
Cause of Death Worksheets The following are ten worksheets to help you practice the six steps required for consistent coding. The answer keys are located at the end. Try not to look at the answers until
Patterns of adherence to antiretroviral therapy (ART) and risk factors for poor adherence in a university hospital HIV clinic in Uganda. Leonard Moore, MS-IV GE/NMF Medical Scholars Program Morehouse School
Sickle Cell Disease Treatment: Important Information for Patients and Health Care Providers Sickle cell disease (SCD) is a group of genetic blood disorders that can cause complications ranging from mild,
Reducing Delays in TB Diagnosis: Data Collection Tools to evaluate the cause and frequency of TB delays April 2011 This document has been developed by the TB CARE II project and is made possible by the
Malaria prevention and treatment INTEGRATED MANAGEMENT OF PREGNANCY AND CHILDBIRTH (IMPAC) Standards for Maternal and Neonatal Care The standard In malarious areas, all pregnant women should sleep under
Original Research Article Home-based temperature measuring practices and their association with selected events of disease sequelae among children treated as dengue in a tertiary care setting in Sri Lanka
MATERNAL AND CHILD HEALTH 9 Ann Phoya and Sophie Kang oma This chapter presents the 2004 MDHS findings on maternal and child health in Malawi. Topics discussed include the utilisation maternal and child
Frequently asked questions about whooping cough (pertussis) About whooping cough What is whooping cough? Whooping cough is a highly contagious illness caused by bacteria. It mainly affects the respiratory
96 INTERIM MANAGEMENT GUIDELINES FOR MEASLES Prepared by Pediatric Infectious Disease Society of the Philippines Measles is a highly contagious viral disease affecting mostly children. There is no specific
The Public Health Crisis in Kenya: An Inside Perspective on the Medical and Economic Challenges Mark Weisburst, MD, MBA, FACC, FACP Stanford Medical School Hartford Hospital University of Hartford Business
NICU TB Exposure and Investigation Frequently Asked Questions When did the health department investigation begin? The Summit County Health District was notified Jan. 3 and immediately began an investigation
CHAPTER 7 SUMMARY Anaemia is an inevitable consequence of Plasmodium falciparum malaria infection, especially in areas of high malaria transmission. In these settings, the group at highrisk for malaria-associated
Frequently asked questions for malaria 1. What is malaria? Malaria is an infectious disease caused by a parasite that is transmitted through bite of an infected mosquito at night. There are two main types
Microdata Library Uganda - Malaria Indicator Survey 2014-2015 Uganda Bureau of Statistics (UBOS) - Government of Uganda, National Malaria Control Programme (NMCP) - Uganda Ministry of Health Report generated
Prevalence of falciparum malaria together with acute diarrhoea in children residing in a malaria endemic zone Theresa K. Nkuo-Akenji*, Olga N. Menang Faculty of Science, Department of Life Sciences, University
EDCTP Stakeholder Meeting on Malaria 19-20 September 2013 Austrian Ministry of Science and Research Recent research advances in malaria prevention and control Prof. Abdoulaye Djimde, University of Science,
atovaquone and proguanil Pronunciation: a TOE va kwone and pro GWAHN il Brand: Malarone, Malarone Pediatric What is the most important information I should know about atovaquone and proguanil? You should
The Contribution of Traditional Medicine in Treatment and Care in HIV/AIDS- The THETA Experience in Uganda THETA background information THETA is an acronym that stands for: Traditional and modern Health
Trends Of Malaria Situation In Jamnagar District Dr. Naresh Makwana*, Dr.Viral Shah **, Dr. Harshad Patel*, Dr. Kalpesh Goswami ***, Dr. Mahesh Choudhary***, Dr. Sudha Yadav **** * Associate Professor,
Contraindications Contraindications to hepatitis A vaccination include a known allergy to any of the vaccine components. General Currently, four inactivated vaccines against HAV are internationally available.
Outcome of children with asthma syndrome and pneumonia in Mulago hospital, Uganda Dr. Rebecca Nantanda Supervisors: Prof. JK Tumwine, Makerere University Prof MS Ostergaard, University of Copenhagen. 1
Before starting your patients on Soliris. Important safety information for the healthcare provider Prior to initiating Soliris (eculizumab) therapy, it s important to review with patients the Soliris Patient
Brief Reports Management of Diarrhea in a DTU C.S. Kamala H.M. Vishwanathakumar P.M. Shetti N. Anand Diarrheal disease continues to be one of the major causes of mortality and morbidity in India and in