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Managing the sick child in the era of declining malaria transmission : development of ALMANACH, an electronic algorithm for appropriate use of antimicrobials

Rambaud-Althaus, Clotilde and Shao, Amani Flexson and Kahama-Maro, Judith and Genton, Blaise and d'Acremont, Valérie. (2015) Managing the sick child in the era of declining malaria transmission : development of ALMANACH, an electronic algorithm for appropriate use of antimicrobials. PLoS ONE, Vol. 10, H. 7 , e0127674.

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Official URL: http://edoc.unibas.ch/dok/A6411219

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Abstract

To review the available knowledge on epidemiology and diagnoses of acute infections in children aged 2 to 59 months in primary care setting and develop an electronic algorithm for the Integrated Management of Childhood Illness to reach optimal clinical outcome and rational use of medicines.; A structured literature review in Medline, Embase and the Cochrane Database of Systematic Review (CDRS) looked for available estimations of diseases prevalence in outpatients aged 2-59 months, and for available evidence on i) accuracy of clinical predictors, and ii) performance of point-of-care tests for targeted diseases. A new algorithm for the management of childhood illness (ALMANACH) was designed based on evidence retrieved and results of a study on etiologies of fever in Tanzanian children outpatients.; The major changes in ALMANACH compared to IMCI (2008 version) are the following: i) assessment of 10 danger signs, ii) classification of non-severe children into febrile and non-febrile illness, the latter receiving no antibiotics, iii) classification of pneumonia based on a respiratory rate threshold of 50 assessed twice for febrile children 12-59 months; iv) malaria rapid diagnostic test performed for all febrile children. In the absence of identified source of fever at the end of the assessment, v) urine dipstick performed for febrile children >2years to consider urinary tract infection, vi) classification of 'possible typhoid' for febrile children <2 years with abdominal tenderness; and lastly vii) classification of 'likely viral infection' in case of negative results.; This smartphone-run algorithm based on new evidence and two point-of-care tests should improve the quality of care of >5 year children and lead to more rational use of antimicrobials.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Health Interventions > Clinical Epidemiology (Genton)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
UniBasel Contributors:Shao, Amani Flexon and Genton, Blaise and D'Acremont, Valérie
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Public Library of Science
e-ISSN:1932-6203
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:31 Aug 2018 06:38
Deposited On:07 Aug 2015 12:06

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