Diagnostic and prescribing practices in peripheral health facilities in rural western Kenya.
Health facility ledgers of 11 rural health facilities in western Kenya were reviewed to evaluate diagnostic and prescribing practices. Clinics lacked laboratory facilities. Of 14,267 sick child visits (SCVs), 76% were diagnosed with malaria and/or upper respiratory infections. Other diagnoses were recorded in less than 5% of SCVs. Although two-thirds of malaria cases were diagnosed with co-infections, less than 3% were concomitantly diagnosed with anemia. Chloroquine and penicillin constituted 94% of prescriptions. Half of children given a sole diagnosis of measles or pneumonia were prescribed chloroquine, and 22% of children with a sole diagnosis of malaria were given penicillin. Antimalarials other than chloroquine were rarely prescribed. Only 12% of children diagnosed with anemia were prescribed iron supplementation, while 53% received folic acid. This study highlights limited diagnostic and prescribing practices and a lack of adherence to national treatment guidelines in rural western Kenya.
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Penelope A
PA
Phillips-Howard
Kathleen A
KA
Wannemuehler
Feiko O
FO
ter Kuile
William A
WA
Hawley
Margarette S
MS
Kolczak
Amos
A
Odhacha
John M
JM
Vulule
Bernard L
BL
Nahlen
D000367:Age Factors; D044383:Black People; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005006:Ethnicity; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D019035:Rural Health Services / Q000706:statistics & numerical data*