Table 3 . Monitoring Visits: classification and treatment of sick children by IMCI course .
| Classification | Observations a | P -value* | |
|
7-Day course
N (95% CI) |
11-Day course
N (95% CI) |
||
| Number | 75 | 72 | |
| Mean No. classifications per child | 1.9 (1.6, 2.1) | 2.1 (1.8, 2.3) | 0.22 |
| N (%) | N (%) | ||
| Severe classification1 | 0 | 0 | - |
| Acute respiratory Infection | 46 (61.3) | 50 (69.4) | 0.30 |
| Pneumonia | 10 (21.7) | 14 (28.0) | 0.48 |
| Acute otitis media (AOM) | 19 (41.3) | 18 (36.0) | 0.59 |
| Pharyngitis | 2 (4.3) | 2 (4.0) | 0.93 |
| Cough/URI | 21 (45.6) | 29 (58.0) | 0.11 |
| Diarrhoea | 44 (58.6) | 36 (50.0) | 0.17 |
| Diarrhoea + dehydration | 10 (22.7) | 4(11.1) | 0.17 |
| Simple diarrhoea | 31 (70.4) | 31 (86.1) | 0.09 |
| Dysentery | 4 (9.1) | 3 (8.3) | 0.91 |
| Persistent diarrhoea | 3 (6.8) | 0 | - |
| Fever | 47 (62.7) | 49 (68.1) | 0.51 |
| Measles (complicated or not) | 0 | 0 | |
| Malaria | 26 (55.3) | 35 (71.4) | <0.01 |
| Other illness | 21 (44.6) | 13 (26.5) | 0.09 |
| Malnutrition (all) | 3 (5.3) | 2 (2.7) | 0.68 |
| Very low weight | 3 (100.0) | 2 (100.0) | |
| Severe malnutrition | 0 | 0 | - |
| Anaemia (all) | 0 | 1 (1.4) | 0.31 |
| Anaemia | 0 | 1 (100.0) | - |
| Severe anaemia | 0 | 0 | - |
| None | 0 | 0 | - |
| Treatment | Mean (95% CI) | Mean (95% CI) | |
| No. drugs per child (95% CI) | 1.6 (1.3, 1.8) | 1.7 (1.5, 2.0) | 0.33 |
| No. drugs per classification per child | 0.9 (0.7, 1.0) | 0.9 (0.8, 1.0) | 0.92 |
| N (%) | N (%) | ||
| Classification requiring antibioticsb | 29 (38.6) | 30 (41.2) | 0.72 |
| Given antibiotic | 28 (96.5) | 28 (93.3) | 0.51 |
| No antibiotic given | 1 (3.4) | 2 (6.7) | 0.50 |
| Classification of diarrhoeac | 44 (58.7) | 36 (50.0) | 0.29 |
| Given ORS and zinc | 42 (95.5) | 36 (100.0) | 0.22 |
| Not given ORS and zinc | 2 (4.5) | 0 | - |
| Given anti-motility drug | 0 | 0 | - |
| Classification requiring ORS or antibiotic | 59 (78.7) | 53 (73.6) | 0.09 |
| Given appropriate ORS or antibiotic | 58 (98.3) | 52 (98.1) | - |
| Not giving appropriate ORS or antibiotic | 1 (1.7) | 1 (1.9) | - |
| Classified as malariad | 26 (34.7) | 35 (48.6) | 0.32 |
| Given anti-malarial | 26 (100.0) | 35 (100.0) | - |
| Not given anti-malarial | 0 | 0 | - |
| Summary scores | % (95% CI) | % (95% CI) | |
| Assessment score | 92.6 (90.8, 94.5) | 93.6 (91.4, 95.8) | 0.51 |
| Classification score | 94.7 (89.5, 99.9) | 95.6 (91.1, 100.0) | 0.72 |
| Treatment score | 94.7 (89.8, 99.5) | 97.2 (94.5, 99.9) | 0.39 |
| Counselling score | 81.2 (76.4, 86.1) | 80.0 (75.1, 84.9) | 0.68 |
| Duration score | 25.8 (24.1, 27.4) | 23.1 (21.4, 24.8) | 0.03 |
IMCI= Integrated Management of Childhood Illness; ORS= oral rehydration salts.
1Severe classification includes all cases that require immediate referral: very severe disease, severe pneumonia, diarrhea with severe dehydration, very severe febrile disease, severe complicated measles, severe malnutrition and mastoiditis. These classifications are included in the broad categories of ARI, diarrhea, fever, malnutrition but are not included in the specific categories under each of these headings.
aMore than one classification per child resulted in sums of proportions adding to more than 100%
bAccording to algorithms in IMCI chart booklet: pneumonia, dysentery, very severe fever, any complications of measles, mastoiditis, acute otitis media, strep throat
cDiarrhoea with or without dehydration, dysentery, persistent diarrhoea of any severity
dMalaria or very severe febrile disease
*Chi-Square statistic; statistical significance= 0.05