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首页> 外文期刊>Annals of Tropical Paediatrics >Care-seeking in the development of severe community acquired pneumonia in Ugandan children.
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Care-seeking in the development of severe community acquired pneumonia in Ugandan children.

机译：乌干达儿童严重社区获得性肺炎的发展过程中寻求照顾。

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BACKGROUND: Improved case management of paediatric pneumonia is recognised as a key strategy for pneumonia control. Since symptoms of pneumonia and malaria often overlap, there are concerns that children with pneumonia are treated with antimalarial drugs. There is a need to describe how children with severe pneumonia have been managed prior to their arrival at hospital, including possible risks of developing more severe disease. METHODS: A case-series study of 140 children, aged 2-59 months, with severe radiologically verified pneumonia at Mulago Hospital, Kampala was undertaken. Caretakers were interviewed about initial symptoms, treatment given and care sought. Using WHO definitions, children were clinically classified as having severe or very severe pneumonia. RESULTS: The children had been ill for a median of 7 days before arrival at hospital, 90/140 (64%) had received treatment at home, and 72/140 (51%) had seen another health-care provider prior to presentation at hospital. Altogether, 32/140 (23%) children had reportedly received antibiotics only prior to admission, 18/140 (13%) had received anti-malarials only and 35/140 (25%) had received both. Being classified as very severe pneumonia was more common among children who had received anti-malarials only (OR 5.5, 1.8-16.4). CONCLUSIONS: Although the majority of caretakers were able to recognise the key symptoms of pneumonia, they did not respond with any immediate care-giving action. Since progression from first recognition of pneumonia symptoms to severe disease is rapid, management guidelines regarding timing of care-seeking need to be clearly defined. The reason why children who sought health facility care failed to improve should be investigated. Meanwhile, there is a need to increase caretakers' and health workers' awareness of the urgency to act promptly when key pneumonia symptoms are observed.
机译：背景：改善小儿肺炎的病例管理被认为是控制肺炎的关键策略。由于肺炎和疟疾的症状经常重叠，因此人们担心患有肺炎的儿童会接受抗疟疾药物的治疗。有必要描述重症肺炎患儿入院前如何进行治疗，包括可能患上更严重疾病的风险。方法：在坎帕拉穆拉戈医院对140名2至59个月大，经放射学证实为严重肺炎的儿童进行了病例系列研究。就初始症状，给予的治疗和寻求的护理对看护者进行了采访。根据世界卫生组织的定义，儿童在临床上被分为患有严重或非常严重的肺炎。结果：这些孩子在到达医院之前平均病了7天，有90/140（64％）的孩子在家中接受过治疗，有72/140（51％）的孩子在就诊前就诊了。医院。据报告，总共有32/140（23％）名儿童仅在入院前接受了抗生素，18/140（13％）名儿童仅接受了抗疟药，而35/140（25％）名儿童均接受了抗疟药。在仅接受抗疟疾的儿童中，被归类为非常严重的肺炎（OR 5.5，1.8-16.4）。结论：尽管大多数看护者能够识别出肺炎的关键症状，但他们没有采取任何立即的看护行动来应对。由于从最初认识到肺炎症状到严重疾病的进展很快，因此需要明确定义有关就医时间的管理指南。寻求医疗保健的儿童未能改善的原因应进行调查。同时，有必要提高看护者和卫生工作者对当发现关键性肺炎症状时立即采取行动的紧迫性的认识。

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