Fever is a very common complaint in children and is the single most common non-trauma-related reason for a visit to the emergency department.Parents are concerned about fever and it's potential complications.The b...Fever is a very common complaint in children and is the single most common non-trauma-related reason for a visit to the emergency department.Parents are concerned about fever and it's potential complications.The biological value of fever(i.e.,whether it is beneficial or harmful) is disputed and it is being vigorously treated with the belief of preventing complications such as brain injury and febrile seizures.The practice of alternating antipyretics has become widespread at home and on paediatric wards without supporting scientific evidence.There is still a significant contrast between the current concept and practice,and the scientific evidence.Why is that the case in such a common complaint like fever? The article will discuss the significant contrast between the current concepts and practice of fever management on one hand,and the scientific evidence against such concepts and practice.展开更多
Malawi is resource poor country in Africa with one of the highest infant and child mortality rates in the world. Malaria is one of the major causes of morbidity and mortality among children in Malawi. Studies have sho...Malawi is resource poor country in Africa with one of the highest infant and child mortality rates in the world. Malaria is one of the major causes of morbidity and mortality among children in Malawi. Studies have shown barriers to care of sick children and the formal health sector has shown sub-optimal patient assessments and overreliance on antibiotic treatment of a child with fever. In 2017, a team of students from Korea and USA audited clinic registers of six health centres under the hospital’s administration of Kasungu District in Malawi for the year of 2016. The clinics were included in the study were those that contributed to the largest number of patients in the district annually. The aim of the audit was to examine treatment outcomes of all children presenting with fever and on whom a definitive diagnosis or presumptive diagnosis of malaria was made at the 6 chosen clinics in Kasungu for improvement of health information system for the district health office. The number of children with malaria ranged between 80 and 440 per month, with the peak occurring between the rainy months of February to May. Peak mortality rate occurred in September and November at 21%. Patients presented with multiple symptoms of fever, convulsion, pallor, vomiting, cough, diarrhea, abdominal pain and headache. Average mortality rate differed between traditional authorities, ranging from 4% to 15%. Off-season high mortality finding promotes more studies looking into socioeconomic and hospital support. Multiple symptoms among patients treated for malaria is a common finding emphasizing the need to integrate household practices for malaria prevention, good malaria case management and linkage with community care of childhood illness (CCM) programs at the clinics in the district.展开更多
文摘Fever is a very common complaint in children and is the single most common non-trauma-related reason for a visit to the emergency department.Parents are concerned about fever and it's potential complications.The biological value of fever(i.e.,whether it is beneficial or harmful) is disputed and it is being vigorously treated with the belief of preventing complications such as brain injury and febrile seizures.The practice of alternating antipyretics has become widespread at home and on paediatric wards without supporting scientific evidence.There is still a significant contrast between the current concept and practice,and the scientific evidence.Why is that the case in such a common complaint like fever? The article will discuss the significant contrast between the current concepts and practice of fever management on one hand,and the scientific evidence against such concepts and practice.
文摘Malawi is resource poor country in Africa with one of the highest infant and child mortality rates in the world. Malaria is one of the major causes of morbidity and mortality among children in Malawi. Studies have shown barriers to care of sick children and the formal health sector has shown sub-optimal patient assessments and overreliance on antibiotic treatment of a child with fever. In 2017, a team of students from Korea and USA audited clinic registers of six health centres under the hospital’s administration of Kasungu District in Malawi for the year of 2016. The clinics were included in the study were those that contributed to the largest number of patients in the district annually. The aim of the audit was to examine treatment outcomes of all children presenting with fever and on whom a definitive diagnosis or presumptive diagnosis of malaria was made at the 6 chosen clinics in Kasungu for improvement of health information system for the district health office. The number of children with malaria ranged between 80 and 440 per month, with the peak occurring between the rainy months of February to May. Peak mortality rate occurred in September and November at 21%. Patients presented with multiple symptoms of fever, convulsion, pallor, vomiting, cough, diarrhea, abdominal pain and headache. Average mortality rate differed between traditional authorities, ranging from 4% to 15%. Off-season high mortality finding promotes more studies looking into socioeconomic and hospital support. Multiple symptoms among patients treated for malaria is a common finding emphasizing the need to integrate household practices for malaria prevention, good malaria case management and linkage with community care of childhood illness (CCM) programs at the clinics in the district.
