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Case management of severe malaria - a forgotten practice: experiences from health facilities in Uganda

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Show simple item record Achan, J. Tibenderana, J. Kyabayinze, D. Mawejje, H. Mugizi, R. Mpeka, B. Talisuna, A. D'Alessandro, U. 2011-03-22T16:27:16Z 2011-03-22T16:27:16Z 2011
dc.identifier.issn 1932-6203
dc.identifier.other ITG-PLA
dc.identifier.other PARAS
dc.identifier.other U-MALAR
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other FTA
dc.identifier.other Electronic
dc.identifier.other Abstract
dc.identifier.other UPD32
dc.description.abstract INTRODUCTION: Severe malaria is a life-threatening medical emergency and requires prompt and effective treatment to prevent death. There is paucity of published information on current practices of severe malaria case management in sub-Saharan Africa; we evaluated the management practices for severe malaria in Ugandan health facilities METHODS AND FINDINGS: We did a cross sectional survey, using multi-stage sampling methods, of health facilities in 11 districts in the eastern and mid-western parts of Uganda. The study instruments were adapted from the WHO hospital care assessment tools. Between June and August 2009, 105 health facilities were surveyed and 181 health workers and 868 patients/caretakers interviewed. None of the inpatient facilities had all seven components of a basic care package for the management of severe malaria consistently available during the 3 months prior to the survey. Referral practices were appropriate for <10% (18/196) of the patients. Prompt care at any health facility was reported by 29% (247/868) of patients. Severe malaria was correctly diagnosed in 27% of patients (233).Though the quinine dose and regimen was correct in the majority (611/868, 70.4%) of patients, it was administered in the correct volumes of 5% dextrose in only 18% (147/815). Most patients (80.1%) had several doses of quinine administered in one single 500 ml bottle of 5% dextrose. Medications were purchased by 385 (44%) patients and medical supplies by 478 patients (70.6%). CONCLUSIONS: Management of severe malaria in Ugandan health facilities was sub-optimal. These findings highlight the challenges of correctly managing severe malaria in resource limited settings. Priority areas for improvement include triage and emergency care, referral practises, quality of diagnosis and treatment, availability of medicines and supplies, training and support supervision. en
dc.language English en
dc.subject Protozoal diseases en
dc.subject Malaria en
dc.subject Plasmodium falciparum en
dc.subject Vectors en
dc.subject Mosquitoes en
dc.subject Severe infection en
dc.subject Case management en
dc.subject Evaluation en
dc.subject Practices en
dc.subject Health facilities en
dc.subject Referral system en
dc.subject Emergency care en
dc.subject Diagnosis en
dc.subject Drug dosing en
dc.subject Drug regimens en
dc.subject Quinine en
dc.subject Uganda en
dc.subject Africa, East en
dc.title Case management of severe malaria - a forgotten practice: experiences from health facilities in Uganda en
dc.type Article-E en
dc.citation.issue 3 en
dc.citation.jtitle PLoS ONE en
dc.citation.volume 6 en
dc.citation.pages e17053 en
dc.citation.jabbreviation PLoS ONE en

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