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Journal article

Differences in diagnosis, management, and outcomes of acute febrile illness by health facility level in southern Ethiopia

Abstract:
We assessed the diagnosis, management and outcomes of acute febrile illness in a cohort of febrile children aged under 5 years presenting at one urban and two rural health centres and one tertiary hospital between 11 August 2019 and 01 November 2019. Pneumonia was diagnosed in 104 (30.8%) of 338 children at health centres and 128 (65.0%) of 197 at the hospital (p < 0.001). Malaria was detected in 33 (24.3%) of 136 children at the urban health centre, and in 55 (55.6%) of 99 and 7 (7.4%) of 95 children at the rural health centres compared to 11 (11.6%) of 95 at the hospital. Antibacterials were prescribed to 20 (11.5%) of 174 children without guidelines-specified indications (overprescribing) at health centres and in 7 (33.3%) of 21 children at the hospital (p = 0.013). Antimalarials were overprescribed to 13 (7.0%) of 185 children with negative malaria microscopy at the hospital. The fever resolved by day 7 in 326 (99.7%) of 327 children at health centres compared to 177 (93.2%) of 190 at the hospital (p < 0.001). These results suggest that additional guidance to health workers is needed to optimise the use of antimicrobials across all levels of health facilities.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1038/s41598-022-23641-8

Authors


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Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
ORCID:
0000-0002-4522-2788


Publisher:
Springer Nature
Journal:
Scientific Reports More from this journal
Volume:
12
Issue:
1
Article number:
19166
Place of publication:
England
Publication date:
2022-11-10
Acceptance date:
2022-11-03
DOI:
EISSN:
2045-2322
Pmid:
36357441


Language:
English
Keywords:
Subjects:
Pubs id:
1308203
Local pid:
pubs:1308203
Deposit date:
2023-04-12

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