Abstract:
A cross-sectional study was conducted during the period of June to July 2001, to
evaluate the IMCI initiative in the diagnosis of febrile illness in Magu district,
Mwanza, Tanzania. In this study, 23 clinicians and 375 underfive patients were
studied.
The study revealed that the IMCI algorithms addressed most of the febrile problems
presented by the caretakers of the sick children.
The study also found that most of the clinicians (96%), had adequate knowledge in
IMCI but the knowledge they had did not go hand in hand with their practice. A
history of cough was enquired in only about half of the children who presented with
,
fever. History of convulsions, being one of the danger signs, was asked for in only
8% of the febrile children and respiratory rate was taken in only 43% of children who
presented with cough. Body temperature was measured in 83% of the children with a
history of fever.
Most of the health facilities had the required diagnostic tools.
The mean time clinicians spent with the sick children was very short (about 5
minutes) despite that the clinics were not busy. The mean workload of clinicians was
about 20 patients per day.
The laboratory results helped in the diagnosis of malaria. It confirmed the absence of
parasitaemia to some febrile children. Following the IMCI algorithms, all those
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IX
children were to be over treated with antimalarials. The findings showed that, the
IMCI algorithms had a high sensitivity (88.1%), and a low specificity (24.7%), in the
diagnosis of malaria.
It is suggested that the findings and recommendations of this study should be used to
improve the diagnosis of febrile illness in primary health care facilities.
