Clinical Diagnosis of Severe Diseases According to IMCI among Children in a Tertiary Care Hospital- A Cross-Sectional Study

Abstract

Introduction: IMCI is a systemic approach to children’s health which focuses not only on curative care but also on prevention of disease. The objectives of the strategy are to reduce death and the frequency and severity of illness and disability. The IMCI integrates management of five most important causes of childhood deaths, namely acute respiratory infections, diarrhoeal diseases, measles, malaria and malnutrition. IMCI is based on clinical assessment and classification of illness that is independent of laboratory assistance. Aim of the study: The aim of this study was to find out the clinical diagnosis of very severe diseases according to IMCI from 2 months to 5 years old children. Methods: This was a cross-sectional study and was conducted in the Department of Paediatrics of Rajshahi Medical College Hospital, Rajshahi, Bangladesh during the period from February, 2014 to July, 2014. We included 100 children having any general danger signs with cough or difficult breathing in our study. Result: In our study we found the mean age was 15.7 months. Most of 57% were male and 43% were female. Most 55(81.81%) of the patients have two or more co-existent general danger sign as per IMCI algorithm. The patients having any general danger sign along with cough or difficult breathing IMCI classified them severe pneumonia but physicians diagnosed them as bronchopneumonia 5%, bronchopneumonia with impending heart failure 6%, bronchopneumonia with heart failure 6%, acute bronchiolitis 1%, pleural effusion 1%, pulmonary TB 1%, pneumonic consolidation 1%. The patients having fever with danger sign IMCI classify them as very severe diseases but physicians clinically diagnosed them as febrile convulsion 30%, meningitis 25%, encephalitis 13%, septicaemia 5%, seizure disorder 3%, meningoencephalitis 2%. Conclusion: IMCI approach has been developed for field and primary care facilities to systematically evaluate and treat patients or identify those requiring higher level of health ...