Management of Childhood Febrile Illness Prior to Clinic Attendance in Urban Nigeria

Parents and caregivers often try various treatment modalities for their sick children before bringing them to clinic. Many community-based studies have documented home and self-treatment practices, often with the aid of patent medicine vendors, but less is known about prior treatment behaviour of caregivers who actually reach a government clinic. This study, therefore, aimed at documenting the treatment provided by caregivers prior to their attendance at a public hospital. Beginning in April 1996, a year-long study was conducted among 1,943 sick children and their caregivers who attended the largest government-owned paediatric hospital in Lagos, Nigeria. The major complaints mentioned by the caregivers included fever, cough, and diarrhoea. Most (89%) caregivers had administered some form of medicine to the child prior to the clinic visit, and on average, 2.5 medications had been given. Associations were found between major complaint and type of medicine given: fevers were associated with antimalarial drugs and analgesics (antipyretics), cough was associated with cough syrup and analgesics, while diarrhoea was associated with antidiarrhoeal drugs. Although one-fifth of the children had received an antibiotic, provision of antibiotics was not associated with a particular complaint/illness. Since caregivers appeared to use perceived complaints/illnesses as a treatment guide, this can form the basis of safer and more appropriate recognition of illness and home management. In addition, the information obtained in this study can be used for training clinicians to inquire about home management and, thus, for making more informed decisions about their own treatment and prescribing practices

Management of Childhood Febrile Illness Prior to Clinic Attendance in Urban Nigeria

Parents and caregivers often try various treatment modalities for their sick children before bringing them to clinic. Many community-based studies have documented home and self-treatment practices, often with the aid of patent medicine vendors, but less is known about prior treatment behaviour of caregivers who actually reach a government clinic. This study, therefore, aimed at documenting the treatment provided by caregivers prior to their attendance at a public hospital. Beginning in April 1996, a year-long study was conducted among 1,943 sick children and their caregivers who attended the largest government-owned paediatric hospital in Lagos, Nigeria. The major complaints mentioned by the caregivers included fever, cough, and diarrhoea. Most (89%) caregivers had administered some form of medicine to the child prior to the clinic visit, and on average, 2.5 medications had been given. Associations were found between major complaint and type of medicine given: fevers were associated with antimalarial drugs and analgesics (antipyretics), cough was associated with cough syrup and analgesics, while diarrhoea was associated with antidiarrhoeal drugs. Although one-fifth of the children had received an antibiotic, provision of antibiotics was not associated with a particular complaint/illness. Since caregivers appeared to use perceived complaints/illnesses as a treatment guide, this can form the basis of safer and more appropriate recognition of illness and home management. In addition, the information obtained in this study can be used for training clinicians to inquire about home management and, thus, for making more informed decisions about their own treatment and prescribing practices

Effect of baseline lipid levels I: influence on plasma total cholesterol and triglyceride changes during treatment of hypertension with a combination of hydrochlorothiazide and amiloride [Moduretic]

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Prévalence du paludisme au moment de l'inscription chez les clients pour le service prénatal auprès d'un Centre de santé secondaire à Ibadan, Nigeria

The prevalence of malaria parasitemia at booking was studied in 1,848 pregnant women in a secondary hospital in Ibadan, Nigeria. Main outcome variables were patent parasitemia and fever. 8.4% had patent malaria parasitaemia. Most clients (89%) with parasitemia were asymptomatic. Febrile subjects booked at an earlier gestational age [22.7 versus 24.2 weeks] than afebrile patients (p = 0.0052). Anemia was more prevalent among patients with patent parasitemia than those without (58.1% versus 22.6%, p<0.0001). Malaria parasitaemia was higher among nulliparous women than other parity groups (p<0.0001). Symptomatic malaria was associated with early booking for antenatal care and malaria parasitemia was a significant determinant of anemia. The prevalence of malaria parasitaemia in this study is much lower than in previous reports.L&apos; étude sur la prévalence de la parasitémie du paludisme au moment de l&apos;inscription a été menée auprès des 1,848 femmes enceintes dans un hôpital secondaire à Ibadan, Nigéria. Les principaux variables de résultat étaient la parasitémie évidente et la fièvre. 8.4 % (155/1848) avaient la parasitémie du paludisme évidente. La plupart des sujets (89%) qui avaient la parasitémie étaient asymptomatiques. Les sujets fébriles se sont inscrites à un âge gestationnel plus jeune [22,7 semaines par opposition à 24,2 semaines] que les patientes afébriles (p=0,0052). L&apos;anémie était plus significativement prévalente chez les patientes qui avaient la parasitémie évidente (58, 1%) par rapport à des patientes qui n&apos;en avaient pas (58,1% contre, 22,6%, p<0,0001). Les femmes nullipares avaient une incidence plus élevée de la parasitémie du paludisme par rapport aux autres groupes de parité (p<0001). La prévalence du paludisme dans cette étude est beaucoup inférieure par rapport aux résultats signalés dans le passé. Le paludisme symptomatique a été lié à l&apos;inscription précoce pour le service prénatal et la parasitémie du paludisme était un déterminant important de l&apos;anémie