A comparative study to evaluate diagnostic agreement of IMNCI algorithm in young infants

  • Dr Rishi Bansal Assistant Professor, Department of Pediatrics, S.N. Medical College, Agra, Uttar Pradesh, India.
  • Dr. Ram Kshitij Sharma Lecturer, Department of Pediatrics, S.N. Medical College, Agra, Uttar Pradesh, India
  • Dr. Madhu Nayak Assistant Professor, Department of Pediatrics, S.N. Medical College, Agra, Uttar Pradesh, India
  • Dr. Shehraz Firoz Assistant Professor, Department of Pediatrics, FH Medical College, Tundla, Uttar Pradesh, India
Keywords: IMCI, Diagnostic Agreement, Childhood Illness

Abstract

Background: Under-five and infant mortality constitutes a major health problem in India. To combat this high mortality, IMCI strategy aiming at holistic and integrated approach to child health and development was developed by WHO.

Methods: This study is a comparative study conducted at Emergency and Outpatient Department of Pediatrics FHMC Tundla and SNMC Agra. Total of 200 young infants(0-2months) were taken. Detailed history and examination was done for all enrolled young infants according to IMNCI and for enrolled infants diagnosis and treatment was made in the Pediatric Department and was considered as Gold Standard.

Results: Out of total 200 young infants, 117 were 0-7 days of age and rest 83 were 7- 59 days of age. Of these 109 infants were admitted, and 91 infants were sent home after initial management. There was no mismatch in diagnosis of 48% infants, while partial mismatch in 38.5% infants, over diagnosis in 10.5% and under diagnosis was present in 3% infants of 0-2 months of age.

Conclusion: This study had good diagnostic agreement and only 3%of infants were underdiagnosed.

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References

Nicoll A. Integrated management of childhood illness in resource-poor countries: an initiative from the World Health Organization. Trans R Soc Trop Med Hyg. 2000;94(1):9-11. doi: https://doi.org/10.1016/S0035-9203(00)90418-8.

Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? Lancet. 2003; 361(9376):2226-2234. doi: https://doi.org/10.1016/S0140-6736(03)13779-8.

Pariyo GW, Gouws E, Bryce J, Burnham G. Improving facility-based care for the sick children in Uganda: training is not enough. Health Policy Plan. 2005;20(1):i58-i68. doi: https://doi.org/10.1093/heapol/czi051.

Lawn JE, Consensus S, Zupan J. 4 million neonatal deaths: When? Where? Why? Lancet 2005;365(9462):891-900. doi: https://doi.org/10.1016/S0140-6736(05)71048-5.

Fenn B, Kirkwood BR, Popatia Z, et al. Inequities in neonatal survival interventions: evidence from national survey. Arch Dis Child Fetal Neonatal Ed. 2007;92(5):F361-F366. doi: https://doi.org/10.1136/adc.2006.104836.

Integrated Management of Childhood Illness (IMCI). Available at https://www.who.int/pmnch/media/publications/aonsectionIII_5.pdf accessed on 10 June 2019.

World Health Organization. World Health Report 1999: making a difference. Geneva; WHO, 1999.

Fagbule D, Kalu A. Case management by community health workers of children with acute respiratory infection: Implications for national ARI control programme. J Trop Med Hyg. 1995;98(4):241-224.

Lambrechts T, Bryce J, Orinda V. Integrated Management of Childhood Illness: a summary of first experiences. Bull WHO.1999;77(7):582-594.

Patwari AK, Raina N. Integrated Management of Childhood Illness (IMCI): A Robust Strategy. Indian J Pediatr. 2002;69:41-48. doi: https://doi.org/10.1007/BF02723776.

Pelletier DL, Frongillo EA, Schroeder DG, Habicht JP. The effects of malnutrition on child mortality in developing countries. Bull WHO. 1995;73(4):443-448.

Shah D, Sachdev HPS. Evaluation of WHO / UNICEF algorithm for integrated management of childhood illnesses between the age of two months to five years. Indian Pediatr. 1999;36:767-777.

Gupta R, Sachdev HPS, Shah D. Evaluation of WHO / UNICEF algorithm for integrated management of childhood illnesses between the age of one week to two months. Indian Pediatr. 2000;37:383-390.

Goswami V, Singh V, Dutta AK. Evaluation of simple clinical signs of illness in young infants (0-2 months) and its correlation with WHO IMCI algorithm (7 days-2 months). Indian Pediatr. 2006;43:1042-1049.

World Health Organization. Integrated management of sick child. Bull WHO.1995;73(6):735-740.

Gove S. Integrated management of childhood illness by outpatient health worker. Technical basis and overview. Bull WHO. 1997:75(1):7-24.

What is Integrated Management of Childhood Illness (IMCI)? Available at https://www.who.int/maternal_child_adolescent/child/imci/background/en.

Kaur S, Singh V, Dutta AK, Chandra J. Validation of IMNCI algorithm for young infants (0-2 months) in India. Indian Pediatr. 2011;48(12):955-960. Epub 2011 Mar 15. doi: https://doi.org/10.1007/s13312-011-0155-1.

Bhattacharyya A, Saha SK, Ghosh P, Chatterjee C, Dasgupta S. Study comparing the management decisions by IMNCI algorithm and pediatricians in a teaching hospital for the young infants between 0 to 2 months. Ind J Public Health. 2011;55(4):324-328. doi: https://doi.org/10.4103/0019-557X.92418.

Thummakomma M, Ramesh P, Reddy M, Balram B. Utility of implementing integrated management of neonatal and childhood illness (IMNCI) algorithm in a tertiary care hospital for the young infants of age 0-2 months. J Evid Med Healthcare. 2016;3(89):4868-4872. doi: https://doi.org/10.18410/jebmh/2016/1026.

CITATION
DOI: 10.17511/ijpr.2019.i12.02
Published: 2019-12-21
How to Cite
Bansal, R., Kshitij Sharma, R., Nayak, M., & Firoz, S. (2019). A comparative study to evaluate diagnostic agreement of IMNCI algorithm in young infants. Pediatric Review: International Journal of Pediatric Research, 6(12), 596-601. https://doi.org/10.17511/ijpr.2019.i12.02
Section
Original Article