TABLE 3—
Treatmentsa Administered to or Prescribed for Children Aged 2 to 59 Months With Moderate or Severe IMCI Classifications Who Were Brought to an Outpatient Health Facility for an Initial Consultation in Ouémé Département, Benin
| IMCI Classification (Treatment) | No. With Classification | No. (%) Treated | 95% CI |
| Severe pneumonia or very severe disease | |||
| Recommended treatment (referral and injectable ampicillin and immediate diazepam treatment for convulsions) | 24 | 0 (0) | … |
| “Adequate” treatment (referral and an effective antibiotic and immediate treatment for convulsions with diazepam or phenobarbital)b | 24 | 1 (4.2) | 0, 11.9 |
| Pneumonia (nonsevere) | |||
| Recommended treatment (cotrimoxazole) | 117 | 33 (28.2) | 18.9, 37.6 |
| “Adequate” treatment (an effective antibiotic)b | 117 | 67 (57.3) | 47.6, 67.0 |
| Diarrhea with moderate or no dehydration | |||
| Recommended treatment (oral rehydration solution)c | 52 | 20 (38.5) | 23.4, 53.5 |
| Very severe febrile disease | |||
| Recommended treatment (referral and injectable ampicillin and injectable quinine and treatment for low blood sugar and paracetamol for fever ≥39.0°C and immediate diazepam treatment for convulsions) | 36 | 0 (0) | … |
| “Adequate” treatment (referral and an effective antibiotic and an effective antimalarial and paracetamol for fever ≥39.0°C and immediate treatment for convulsions with diazepam or phenobarbital)b | 36 | 2 (5.6) | 0, 13.1 |
| Malaria (nonsevere) | |||
| Recommended treatment (chloroquine and paracetamol for fever ≥39.0°C) | 301 | 179 (59.5) | 48.7, 70.3 |
| “Adequate” treatment (an effective antimalarial and paracetamol for fever ≥39.0°C)b | 301 | 253 (84.1) | 79.5, 88.6 |
| Acute ear infection | |||
| Recommended treatment (cotrimoxazole and paracetamol) | 23 | 0 (0) | … |
| “Adequate” treatment (an effective antibiotic and paracetamol)b | 23 | 2 (8.7) | 0, 20.6 |
| Severe anemia | |||
| Recommended treatment (urgent referral)c | 29 | 19 (65.5) | 44.2, 86.9 |
| Anemia (nonsevere, among children not needing urgent referral) | |||
| Recommended treatment (iron and folate and chloroquine and mebendazole if aged ≥24 months and last dose was >6 months ago)a | 100 | 15 (15.0) | 6.4, 23.6 |
| “Adequate” treatment (iron and an effective antimalarial and mebendazole or albendazole if aged ≥24 months and last dose was >6 months ago)b | 100 | 45 (45.0) | 34.0, 56.0 |
Note. IMCI = Integrated Management of Childhood Illness; CI = confidence interval; ellipses indicate not available (CIs were not estimated if a proportion = 0).
aOnly drug selection is considered; other aspects (e.g., dosages) are not considered. Recommendations are based on the Benin adaptation of IMCI standards except for nonsevere anemia and choice of antipyretic, which are based on generic World Health Organization standards. “Adequate” treatments were treatments judged by the investigators to be about as effective as the recommended treatments. All drugs are oral unless otherwise stated.
bEffective antibiotics are ampicillin, cotrimoxazole, amoxicillin, erythromycin, and penicillin G. Effective antimalarials are quinine, chloroquine, sulfadoxine-pyrimethamine, halofantrine, and cotrimoxazole. Oral medications are considered effective only if the child is awake, able to drink, not “vomiting everything,” and not having seizures.
cFailure to provide the recommended treatment was considered inadequate; therefore, no “adequate” treatment definition was proposed.