Publication: Introducing the concept of a new pre-referral treatment for severely ill febrile children at community level: a sociological approach in Guinea-Bissau.
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Accepted Date
2014-01-21
Issued Date
2014-02-06
Copyright Date
2014
Resource Type
Language
eng
ISSN
1475-2875 (electronic)
Rights
Mahidol University
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BioMed Central
Bibliographic Citation
Vermeersch A, Libaud-Moal A, Rodrigues A, White NJ, Olliaro P, Gomes M, et al. Introducing the concept of a new pre-referral treatment for severely ill febrile children at community level: a sociological approach in Guinea-Bissau. Malar J. 2014 Feb 6;13:50.
Suggested Citation
Vermeersch, Audrey, Libaud-Moal, Anaëlle, Rodrigues, Amabelia, White, Nicholas J, Olliaro, Piero, Gomes, Melba, Ashley, Elizabeth A, Millet, Pascal Introducing the concept of a new pre-referral treatment for severely ill febrile children at community level: a sociological approach in Guinea-Bissau.. Vermeersch A, Libaud-Moal A, Rodrigues A, White NJ, Olliaro P, Gomes M, et al. Introducing the concept of a new pre-referral treatment for severely ill febrile children at community level: a sociological approach in Guinea-Bissau. Malar J. 2014 Feb 6;13:50.. doi:10.1186/1475-2875-13-50. Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/768
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Title
Introducing the concept of a new pre-referral treatment for severely ill febrile children at community level: a sociological approach in Guinea-Bissau.
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Abstract
BACKGROUND: Innovative strategies are needed to tackle childhood mortality in the
rural tropics. Artesunate suppositories were developed to bring emergency
treatment closer to severely ill children with malaria in rural areas where
injectable treatment is not possible for several hours. Adding an antibacterial
rectal drug would extend this strategy to treat non-malarial febrile illness as
well. The objective of these studies was to assess acceptability of such a new
pre-referral strategy by healthcare providers and likely uptake by the
population.
METHODS: Two qualitative studies were conducted between May and July 2009. Study
1 investigated the acceptability of introducing a combined
antimalarial-antibacterial suppository by interviewing 27 representatives of the
three administrative levels (central government, regional, local) of the health
sector; Study 2 investigated treatment-seeking behaviour and acceptability of
this intervention at community level by interviewing 74 mothers in 2 villages.
RESULTS AND CONCLUSIONS: Up to 92% of health representatives were in favour of
introducing a new pre-referral strategy to tackle both malaria and non-malaria
related severe illnesses in Guinea-Bissau, provided it was endorsed by
international health authorities. The main obstacles to implementation were the
very limited human and financial resources. In the two villages surveyed, 44% of
the mothers associated severe illness with fever only, or fever plus one
additional symptom. Mothers' judgement of severity and ensuing decisions were not
specific for serious illness, indicating that initial training to recognize signs
of severe disease and treatment availability for non-severe, fever-associated
symptoms will be required to prevent overuse of a new intervention designed as a
pre-referral treatment for severely ill children. Level C health centres were the
first resort in both villages (50% and 87% of respondents respectively). This
information is encouraging for the implementation of a pre-referral treatment.