The impact of routine admission tests on the care of Third-World children.
To determine the clinical usefulness of routine diagnostic tests on admission of Third-World children to hospital, the records of 306 children admitted to a Ciskei hospital were examined. The tests performed were 'dipstick' urinalysis, Mantoux testing and bedside haemoglobin measurement. Of the 164 Mantoux tests performed, 16 were unexpectedly positive and 15 (94%) of these 16 patients had their treatment changed as a result. Measurement of the haemoglobin concentration revealed that 31 of 278 patients had a haemoglobin value unexpectedly below 10 g/dl, but in 28 of these 31 cases (90%) this result was ignored. Of the 3 patients followed up, 2 had their treatment changed. An unexpected abnormal result was obtained in 76 of 233 urinalyses performed, but 72 (95%) of these were ignored. Follow-up in the remaining 4 cases did not result in any change in treatment. Routine urine and haemoglobin testing had negligible impact on patient care because unexpected abnormal results were ignored. This finding is similar to those of similar studies on Western adults. The possible reasons for this, and for the striking exception of the Mantoux test, are discussed.
Swingler
G H
GH
Department of Paediatrics, Cecilia Makiwane Hospital, Mdantsane, Ciskei.
D002648:Child; D003906:Developing Countries; D003955:Diagnostic Tests, Routine; D005069:Evaluation Studies as Topic; D006801:Humans; D010347:Patient Care Planning; D010818:Practice Patterns, Physicians'; D013019:South Africa