ArticleBulletin of the World Health Organization2017
Clinical management of children with fever: a cross-sectional study of quality of care in rural Zambia.
Article in Bulletin of the World Health Organization, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 18 citations in OpenAlex.
- Universal versus conditional day 3 follow-up for children with non-severe unclassified fever at the community level in Ethiopia: A cluster-randomised non-inferiority trial.PLoS medicine · 2018Trial
- Know-do gaps in the clinical management of childhood illness: evidence from three countries in sub-Saharan Africa.BMC public health · 2025Observational
- Associations between women's empowerment, care seeking, and quality of malaria care for children: A cross-sectional analysis of demographic and health surveys in 16 sub-Saharan African countries.Journal of global health · 2022Article
- High Frequency of Antibiotic Prescription in Children With Undifferentiated Febrile Illness in Kenya.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Measuring Knowledge of Community Health Workers at the Last Mile in Liberia: Feasibility and Results of Clinical Vignette Assessments.Global health, science and practice · 2021Article
- Viral etiology and seasonal trends of pediatric acute febrile illness in southern Puerto Rico; a seven-year review.PloS one · 2021Article
- High Circulation of Malaria and Low Prevalence of Bacteremia in Febrile and Afebrile Children in Northeastern Gabon.The American journal of tropical medicine and hygiene · 2020Article
- Quality of care for children with severe disease in the Democratic Republic of the Congo.BMC public health · 2019Article
- Addressing malnutrition among children in routine care: how is the Integrated Management of Childhood Illnesses strategy implemented at health centre level in Burundi?BMC nutrition · 2019Article
- Article
- Content of Care in 15,000 Sick Child Consultations in Nine Lower-Income Countries.Health services research · 2018Article
- Distribution and determinants of pneumonia diagnosis using Integrated Management of Childhood Illness guidelines: a nationally representative study in Malawi.BMJ global health · 2018Article
- Comparative Analysis of Rural Health Demographics in 2 East African Communities During Medical Camps: Volunteers' Perspectives'.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate current practices and standards of evaluation and treatment of childhood febrile illness in Southern Province, Zambia.
methodsFrom November to December 2013, we conducted a cross-sectional survey of facilities and health workers and we observed the health workers' interactions with febrile children and their caregivers. The facility survey recorded level of staffing, health services provided by the facility, availability and adequacy of medical equipment, availability of basic drugs and supplies and availability of treatment charts and guidelines. The health worker survey assessed respondents' training, length of service, access to national guidelines and job aids for managing illnesses, and their practice and knowledge on management of neonatal and child illnesses. We also conducted exit interviews with caregivers to collect information on demographic characteristics, chief complaints, counselling and drug dispensing practices.
findingsThis study included 24 health facilities, 53 health workers and 161 children presenting with fever. Facilities were insufficiently staffed, stocked and equipped to adequately manage childhood fever. Children most commonly presented with upper respiratory tract infections (46%; 69), diarrhoea (31%; 27) and malaria (10%; 16). Health workers insufficiently evaluated children for danger signs, and less than half (47%; 9/19) of children with pneumonia received appropriate antibiotic treatment. Only 57% (92/161) were tested for malaria using either rapid diagnostic tests or microscopy.
conclusionVarious health system challenges resulted in a substantial proportion of children receiving insufficient management and treatment of febrile illness. Interventions are needed including strengthening the availability of commodities and improving diagnosis and treatment of febrile illness.
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