Prevalence and correlates of paediatric guideline non-adherence for initial empirical care in six low and middle-income settings: a hospital-based cross-sectional study

Simple item page
dc.contributor.authorShawon, Riffat Ara
dc.contributor.authorDenno, Donna
dc.contributor.authorTickell, Kirkby D
dc.contributor.authorAtuhairwe, Michael
dc.contributor.authorBandsma, Robert
dc.contributor.authorMupere, Ezekiel
dc.contributor.authorVoskuijl, Wieger
dc.contributor.authorMbale, Emmie
dc.contributor.authorAhmed, Tahmeed
dc.contributor.authorChisti, Md Jobayer
dc.contributor.authorSaleem, Ali Faisal
dc.contributor.authorNgari, Moses
dc.contributor.authorDiallo, Abdoulaye Hama
dc.contributor.authorBerkley, James
dc.contributor.authorWalson, Judd
dc.contributor.authorMeans, Arianna Rubin
dc.date.accessioned2024-03-18T12:53:54Z
dc.date.available2024-03-18T12:53:54Z
dc.date.issued2024-03
dc.description.abstractObjectives This study evaluated the prevalence and correlates of guideline non-adherence for common childhood illnesses in low-resource settings.Design and setting We used secondary cross-sectional data from eight healthcare facilities in six Asian and African countries.Participants A total of 2796 children aged 2–23 months hospitalised between November 2016 and January 2019 with pneumonia, diarrhoea or severe malnutrition (SM) and without HIV infection were included in this study.Primary outcome measures We identified children treated with full, partial or non-adherent initial inpatient care according to site-specific standard-of-care guidelines for pneumonia, diarrhoea and SM within the first 24 hours of admission. Correlates of guideline non-adherence were identified using generalised estimating equations.Results Fully adherent care was delivered to 32% of children admitted with diarrhoea, 34% of children with pneumonia and 28% of children with SM when a strict definition of adherence was applied. Non-adherence to recommendations was most common for oxygen and antibiotics for pneumonia; fluid, zinc and antibiotics for diarrhoea; and vitamin A and zinc for SM. Non-adherence varied by site. Pneumonia guideline non-adherence was more likely among patients with severe disease (OR 1.82; 95% CI 1.38, 2.34) compared with non-severe disease. Diarrhoea guideline non-adherence was more likely among lower asset quintile groups (OR 1.16; 95% CI 1.01, 1.35), older children (OR 1.10; 95% CI 1.06, 1.13) and children presenting with wasting (OR 6.44; 95% CI 4.33, 9.57) compared with those with higher assets, younger age and not wasted. Conclusions Non-adherence to paediatric guidelines was common and associated with older age, disease severity, and comorbidities, and lower household economic status. These findings highlight opportunities to improve guidelines by adding clarity to specific recommendations.en_US
dc.identifier.citationShawon, Riffat Ara, Donna Denno, Kirkby D. Tickell, et al. 'Prevalence and Correlates of Paediatric Guideline Non-Adherence for Initial Empirical Care in Six Low and Middle-Income Settings: A Hospital-Based Cross-Sectional Study', BMJ Open, vol. 14/no. 3, (2024), pp. e078404-e078404.en_US
dc.identifier.issnISSN 2044-6055
dc.identifier.issnEISSN 2044-6055
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/9449
dc.language.isoenen_US
dc.publisherBritish Medical Journal Publishing Groupen_US
dc.subjectpaediatric mortality; pneumonia, diarrhoea and severe malnutritionen_US
dc.titlePrevalence and correlates of paediatric guideline non-adherence for initial empirical care in six low and middle-income settings: a hospital-based cross-sectional studyen_US
dc.typeArticleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
e078404.full.pdf
Size:
661.06 KB
Format:
Adobe Portable Document Format
Description:
Journal Article
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Medical and Health Sciences