Validation of an Integrated Management of Childhood Illness algorithm for managing common skin conditions in Fiji.

Objective To assess the sensitivity of an Integrated Management of Childhood Illness (IMCI) algorithm to detect common skin conditions in children in Fiji. Methods We collected data from the assessments of children aged between 2 months and 5 years who presented to one of two health clinics. Every c...

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Publicado en:Bulletin of the World Health Organization Vol. 87; no. 3; pp. 173 - 180
Autores principales: Steer AC, Tikoduadua LV, Manalac EM, Colquhoun S, Carapetis JR, Maclennan C
Formato: research tables/charts Journal Article
Publicado: World Health Organization Mar2009
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2009
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        atl: Validation of an Integrated Management of Childhood Illness algorithm for managing common skin conditions in Fiji.
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        au:
          Steer AC
          Tikoduadua LV
          Manalac EM
          Colquhoun S
          Carapetis JR
          Maclennan C
        affil: Centre for International Child Health, University of Melbourne, Vic., 3052, Australia.
      sug:
        subj:
          Instrument Validation
          Pediatric Care Standards
          Skin Diseases Diagnosis
          Child, Preschool
          Confidence Intervals
          Data Analysis Software
          Data Analysis, Statistical
          Descriptive Statistics
          Female
          Funding Source
          Infant
          kappa Statistic
          Male
          Melanesia
          Pediatric Nursing
          Pediatricians
          Sensitivity and Specificity
          Skin Diseases Symptoms
          Validation Studies
          Human
          Child, Preschool: 2-5 years
          Infant: 1-23 months
          Female
          Male
      ab: Objective To assess the sensitivity of an Integrated Management of Childhood Illness (IMCI) algorithm to detect common skin conditions in children in Fiji. Methods We collected data from the assessments of children aged between 2 months and 5 years who presented to one of two health clinics. Every child was assessed by a nurse trained in the use of the IMCI algorithm and also an expert paediatrician. We used a kappa statistic to measure agreement between the nurse/algorithm assessment method and the paediatrician's diagnosis. Findings High sensitivity for identifying skin problems (sensitivity: 98.7%; 95% confidence interval, CI: 95.5--99.9) was found for the algorithm applied by IMCI-trained nurses, who were able to identify the one child with a severe skin infection and all three children with periorbital cellulitis. Sensitivity was high for the classification of abscess/cellulitis (sensitivity: 95%; 95% CI: 75.1--99.9) and infected scabies (sensitivity: 89.1%; 95% CI: 77.8--95.9), but lower for identification of impetigo, fungal infection and, in particular, non-infected scabies. Conclusion The IMCI skin algorithm is a robust tool that should be incorporated into the IMCI after some modifications relating to scabies and impetigo. Its use by primary health-care workers will reduce the burden of skin diseases in children in Fiji through improved case identification and management. The algorithm should be considered in other countries where skin diseases in children are a priority, particularly in the Pacific region. Copyright © 2009 World Health Organization
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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