Evaluation of IMCI in the diagnosis of febrile illness in magu district, Mw anza, Tanzania

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

~ -- - - -- -- - -- - -- -- ---~~--=- 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.