The integrated management of childhood illness in western Uganda

P. R. Kolstad, Gilbert M Burnham, H. D. Kalter, N. Kenya-Mugisha, Robert E Black

Research output: Contribution to journalArticle

Abstract

Bringing together various disease-specific guidelines for sick children, WHO and UNICEF have developed an Integrated Management of Childhood Illness (IMCI) algorithm, one component of which (assess and classify) was tested in the outpatient department of a rural district hospital in western Uganda. Children aged 2-59 months were seen first by a Ugandan medical assistant trained in IMCI, and then evaluated by a medical officer. Sensitivity, specificity and positive predictive values were determined by comparing the IMCI classifications with a reference standard based on the medical officers' diagnoses and laboratory tests. Of the 1226 children seen, 69% were classified into more than one symptom category, 7% were not classified in any symptom category, 8% had a danger sign, and 16% were classified into a severe category, for which the IMCI approach recommended urgent hospital referral. Specificity for most classifications was good, though sensitivity and positive predictive values were variable. We conclude that the IMCI algorithm is an important advance in the primary care of sick children in developing countries.

Original languageEnglish (US)
Pages (from-to)77-85
Number of pages9
JournalBulletin of the World Health Organization
Volume75
Issue numberSUPPL. 1
StatePublished - 1998

Fingerprint

Uganda
Rural Hospitals
District Hospitals
United Nations
Clinical Laboratory Techniques
Developing Countries
Primary Health Care
Outpatients
Referral and Consultation
Guidelines
Sensitivity and Specificity

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

The integrated management of childhood illness in western Uganda. / Kolstad, P. R.; Burnham, Gilbert M; Kalter, H. D.; Kenya-Mugisha, N.; Black, Robert E.

In: Bulletin of the World Health Organization, Vol. 75, No. SUPPL. 1, 1998, p. 77-85.

Research output: Contribution to journalArticle

Kolstad, PR, Burnham, GM, Kalter, HD, Kenya-Mugisha, N & Black, RE 1998, 'The integrated management of childhood illness in western Uganda', Bulletin of the World Health Organization, vol. 75, no. SUPPL. 1, pp. 77-85.
Kolstad, P. R. ; Burnham, Gilbert M ; Kalter, H. D. ; Kenya-Mugisha, N. ; Black, Robert E. / The integrated management of childhood illness in western Uganda. In: Bulletin of the World Health Organization. 1998 ; Vol. 75, No. SUPPL. 1. pp. 77-85.
@article{8ae1e6e758c848b8a5a01c7aaf382b5d,
title = "The integrated management of childhood illness in western Uganda",
abstract = "Bringing together various disease-specific guidelines for sick children, WHO and UNICEF have developed an Integrated Management of Childhood Illness (IMCI) algorithm, one component of which (assess and classify) was tested in the outpatient department of a rural district hospital in western Uganda. Children aged 2-59 months were seen first by a Ugandan medical assistant trained in IMCI, and then evaluated by a medical officer. Sensitivity, specificity and positive predictive values were determined by comparing the IMCI classifications with a reference standard based on the medical officers' diagnoses and laboratory tests. Of the 1226 children seen, 69{\%} were classified into more than one symptom category, 7{\%} were not classified in any symptom category, 8{\%} had a danger sign, and 16{\%} were classified into a severe category, for which the IMCI approach recommended urgent hospital referral. Specificity for most classifications was good, though sensitivity and positive predictive values were variable. We conclude that the IMCI algorithm is an important advance in the primary care of sick children in developing countries.",
author = "Kolstad, {P. R.} and Burnham, {Gilbert M} and Kalter, {H. D.} and N. Kenya-Mugisha and Black, {Robert E}",
year = "1998",
language = "English (US)",
volume = "75",
pages = "77--85",
journal = "Bulletin of the World Health Organization",
issn = "0042-9686",
publisher = "World Health Organization",
number = "SUPPL. 1",

}

TY - JOUR

T1 - The integrated management of childhood illness in western Uganda

AU - Kolstad, P. R.

AU - Burnham, Gilbert M

AU - Kalter, H. D.

AU - Kenya-Mugisha, N.

AU - Black, Robert E

PY - 1998

Y1 - 1998

N2 - Bringing together various disease-specific guidelines for sick children, WHO and UNICEF have developed an Integrated Management of Childhood Illness (IMCI) algorithm, one component of which (assess and classify) was tested in the outpatient department of a rural district hospital in western Uganda. Children aged 2-59 months were seen first by a Ugandan medical assistant trained in IMCI, and then evaluated by a medical officer. Sensitivity, specificity and positive predictive values were determined by comparing the IMCI classifications with a reference standard based on the medical officers' diagnoses and laboratory tests. Of the 1226 children seen, 69% were classified into more than one symptom category, 7% were not classified in any symptom category, 8% had a danger sign, and 16% were classified into a severe category, for which the IMCI approach recommended urgent hospital referral. Specificity for most classifications was good, though sensitivity and positive predictive values were variable. We conclude that the IMCI algorithm is an important advance in the primary care of sick children in developing countries.

AB - Bringing together various disease-specific guidelines for sick children, WHO and UNICEF have developed an Integrated Management of Childhood Illness (IMCI) algorithm, one component of which (assess and classify) was tested in the outpatient department of a rural district hospital in western Uganda. Children aged 2-59 months were seen first by a Ugandan medical assistant trained in IMCI, and then evaluated by a medical officer. Sensitivity, specificity and positive predictive values were determined by comparing the IMCI classifications with a reference standard based on the medical officers' diagnoses and laboratory tests. Of the 1226 children seen, 69% were classified into more than one symptom category, 7% were not classified in any symptom category, 8% had a danger sign, and 16% were classified into a severe category, for which the IMCI approach recommended urgent hospital referral. Specificity for most classifications was good, though sensitivity and positive predictive values were variable. We conclude that the IMCI algorithm is an important advance in the primary care of sick children in developing countries.

UR - http://www.scopus.com/inward/record.url?scp=0031823929&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031823929&partnerID=8YFLogxK

M3 - Article

VL - 75

SP - 77

EP - 85

JO - Bulletin of the World Health Organization

JF - Bulletin of the World Health Organization

SN - 0042-9686

IS - SUPPL. 1

ER -