title: An instrument to assess acute respiratory infection case management in Egypt.
abstract: To develop an instrument to measure the quality of acute respiratory infection (ARI) case management among Egyptian children.
  
  
  METHODS
  A baseline survey of all health facilities in a single district, using a multi-data source instrument. Data sources included providers, caretakers, patient records and observation of patient care.
  
  
  RESULTS
  Physicians did not count the respiratory rate and check for subcostal retraction. Eighty-seven per cent of children who did not require antibiotics received them. Of five children who required antibiotics, four (80%) were prescribed an oral regimen. Three of these should have been admitted to a hospital but were not. Antibiotics were available at the facilities an estimated 7.9 months per year. Oxygen for inpatient treatment was available in one of two hospitals.
  
  
  CONCLUSIONS
  This instrument was useful for comprehensively evaluating facility capability to provide quality case management. Deficiencies were identified but were not unexpected in a baseline survey. The Egypt ARI program has the potential to have a substantial impact on how children with ARI are diagnosed and treated in health facilities.
authors.affiliation: Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD.
authors.forename: L H
authors.initials: LH
authors.lastname: Harrison
authors.forename: N
authors.initials: N
authors.lastname: Khallaf
authors.forename: M
authors.initials: M
authors.lastname: el Mougi
authors.forename: H
authors.initials: H
authors.lastname: Koura
authors.forename: I
authors.initials: I
authors.lastname: Shobair
authors.forename: N
authors.initials: N
authors.lastname: Terreri
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002662:Child Health Services / Q000592:standards*; D003906:Developing Countries; D004363:Drug Utilization; D004534:Egypt; D006801:Humans; D010347:Patient Care Planning / Q000592:standards; D011787:Quality of Health Care; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents