dc.contributor.author | Tumukunde, Victor Spector | |
dc.date.accessioned | 2015-01-14T12:34:36Z | |
dc.date.available | 2015-01-14T12:34:36Z | |
dc.date.issued | 2014 | |
dc.identifier.citation | Tumukunde, V.S. (2014). The influence of pre-hospital treatment of fever on severity of malaria among children 6-59 months presenting at Mulago Hospital: A case-control study. (Unpublished master's thesis). Makerere University, Kampala, Uganda. | en_US |
dc.identifier.uri | http://hdl.handle.net/10570/4302 | |
dc.description | A Thesis submitted to the School of Graduate Studies in partial fulfillment of the requirements for the award of the Degree of Master of Medicine in Paediatrics and Child Health of Makerere University | en_US |
dc.description.abstract | Introduction: Delivery of prompt and adequate treatment for malaria at the community level remains a strategy to reduce the burden of malaria in sub-Saharan Africa. As a result of this many patients with suspected malaria take anti-malaria medicines in the communities with or without prescription before visiting hospitals/health units. The effect of use of this pre-hospital medication on malaria presentation in the hospital is poorly described.
Objectives: The aims of this study were to determine the influence of pre-hospital treatment of fever on malaria severity among children 6-59 months presenting to Mulago hospital and the factors associated with pre-hospital treatment of fever.
Methodology: We carried out a case-control study at Acute Care Unit Mulago National referral, among children aged between 6-59 months presenting with malaria. We enrolled 100 cases (Children with severe malaria) and 105 controls (children with un-complicated malaria) that were assessed for pre-hospital treatment of fever. Chi square test was used to compute the odds of using pre-hospital treatment among the cases and controls. Multiple logistic regressions were used to determine the factors associated with pre-hospital treatment of fever. Variables with a p-value of ≤0.05 at the multivariate analysis were considered statistically significant.
Results: Overall the level of pre-hospital treatment of fever was 147/205 (71.7%). Of these, 91/147(44.4%) used anti-malaria medicines. 35/83 (42.2%) received medicines from the clinics and 27/83 (32.5%) from hospitals. Receipt of adequate anti-malaria doses was reported in 41/91(45.1%) of patients. Cases had significantly higher Odds of having used pre-hospital medication compared to controls with an odds ratio of 2.52 (95% CI=1.33-4.77 and p-value of 0.004). Use of anti-malaria medicines was also higher among the cases at 58/100 (58%) as compared to controls at 33/105(31.4%) with an odds ratio of 3.01 (95%CI of 1.70-5.34 and p-value of <0.001). But this relationship was not true when only those taking adequate anti-malarial doses were considered with an OR of 1.24(95%CI of 0.53-2.93 and p-value of 0.620).
Having fever for more than three days was significantly associated with use of pre-hospital treatment of fever with an OR of 2.46 (95% CI=1.28-4.73 and a p-value of 0.007). Other factors like age, sex, distance, mother’s level of education and occupation were not significantly associated with use of pre-hospital medication.
Conclusions: Patients with severe malaria were more likely to have taken pre-hospital medications compared to those with uncomplicated malaria. Delay in presentation to Mulago National Referral Hospital of more than three days of fever was associated with use of pre-hospital medication.
Recommendations: There is a need for community sensitization on dangers of using inadequate doses of anti-malaria medicines. Further studies need to be conducted to establish the effect of pre-hospital anti-malaria medicine use on disease progression. | en_US |
dc.description.sponsorship | Uganda Malaria Clinical Operational and Health Services Research (CORHE) | en_US |
dc.language.iso | en | en_US |
dc.publisher | Makerere University | en_US |
dc.subject | Children, 6-59 months | en_US |
dc.subject | Fever | en_US |
dc.subject | Pre-hospital treatment | en_US |
dc.subject | Malaria severity | en_US |
dc.subject | Mulago Hospital, Uganda | en_US |
dc.subject | Sub-Saharan Africa | en_US |
dc.subject | Anti-malaria medicines | en_US |
dc.title | The influence of pre-hospital treatment of fever on severity of malaria among children 6-59 months presenting at Mulago Hospital: A case-control study. | en_US |
dc.type | Thesis/Dissertation (Masters) | en_US |