PMID- 14641851
OWN - NLM
STAT- MEDLINE
DCOM- 20040316
LR  - 20190922
IS  - 1360-2276 (Print)
IS  - 1360-2276 (Linking)
VI  - 8
IP  - 12
DP  - 2003 Dec
TI  - The use of formal and informal curative services in the management of paediatric 
      fevers in four districts in Kenya.
PG  - 1143-52
AB  - OBJECTIVE: To assess the sources, costs, timing and types of treatment for fevers 
      among children under 5 years of age in four ecologically distinct districts of 
      Kenya. METHODS: Structured questionnaires were administered to caretakers of one 
      randomly selected child aged <5 years per homestead to establish whether the 
      child had had a fever within the last 14 days and the types, sources, costs, and 
      timing of treatment. Drug charts of common proprietary anti-malarial and 
      antipyretic drugs in Kenya were used as visual aids. RESULTS: A total of 2655 
      fevers were reported among 6287 (42.2%) children with significant differences 
      between the four districts (P<0.01). A substantial number of fevers remained 
      untreated (28.1%) across all districts and more fevers were treated in Greater 
      Kisii than any other district (P<0.01). The median delay to any treatment was 2 
      days [inter-quartile range (IQR): 2, 4]. The informal retail sector had no 
      transport costs associated with it and charged less for drugs than all the other 
      sectors. Most antimalarial treated fevers occurred in the formal public sector 
      (52.6%). Only 2.3% of fevers were treated within 24 h of onset with a 
      sulphur-pyrimethamine drug, the nationally recommended first-line drug for the 
      management of uncomplicated malaria. CONCLUSIONS: The Abuja target of ensuring 
      that 60% of childhood fevers are treated with appropriate antimalarial drugs 
      within 24 h of onset by 2010 is largely unmet and a major investment in improving 
      prompt access to antimalarial drugs will be required to achieve this.
FAU - Amin, Abdinasir A
AU  - Amin AA
AD  - Kenya Medical Research Institute/Wellcome Trust Collaborative Programme, Nairobi, 
      Kenya. aamin@wtnairobi.mimcom.net
FAU - Marsh, Vicki
AU  - Marsh V
FAU - Noor, Abdisalan M
AU  - Noor AM
FAU - Ochola, Sam A
AU  - Ochola SA
FAU - Snow, Robert W
AU  - Snow RW
LA  - eng
GR  - 081829/Wellcome Trust/United Kingdom
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Trop Med Int Health
JT  - Tropical medicine & international health : TM & IH
JID - 9610576
RN  - 0 (Analgesics, Non-Narcotic)
RN  - 0 (Antimalarials)
SB  - IM
MH  - Analgesics, Non-Narcotic/*administration & dosage/economics
MH  - Antimalarials/*administration & dosage/economics
MH  - Case Management/*standards
MH  - Child, Preschool
MH  - Commerce
MH  - Drug Administration Schedule
MH  - Drug Costs/statistics & numerical data
MH  - Drug Utilization
MH  - Female
MH  - Fever/*drug therapy/epidemiology
MH  - Humans
MH  - Infant
MH  - Kenya/epidemiology
MH  - Male
MH  - Public Sector
MH  - Surveys and Questionnaires
EDAT- 2003/12/03 05:00
MHDA- 2004/03/17 05:00
CRDT- 2003/12/03 05:00
PHST- 2003/12/03 05:00 [pubmed]
PHST- 2004/03/17 05:00 [medline]
PHST- 2003/12/03 05:00 [entrez]
AID - 1140 [pii]
AID - 10.1046/j.1360-2276.2003.01140.x [doi]
PST - ppublish
SO  - Trop Med Int Health. 2003 Dec;8(12):1143-52. doi: 
      10.1046/j.1360-2276.2003.01140.x.