SIGNIFICANCE OF INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI) CHECK SIGNS AND ITS IMPLICATION IN CHILDREN AT PAEDIATRIC OUTDOOR DEPARTMENT

Main Article Content

Muhammad Hanif
Salma Shaikh
Muhammad Chohan Nadeem
Mushtaque Ali Shah

Abstract

OBJECTIVE: To assess the significance of integrated management of childhood illness (IMCI) check signs and its implication in children (aged 2 months to 5 years) at a Paediatric Outdoor Department, Jamshoro/Hyderabad.
METHODS: This cross-sectional study was conducted at a Paediatric Outpatient Department, Liaquat University Hospital, Jamshoro, Hyderabad, Pakistan. The study enrolled 5578 children from July 2015 to June 2016. Children meeting the inclusion criteria were enrolled in study. Detailed history was taken, followed by physical examination of children for assessment of acute malnutrition, anemia, immunization status, mebendazole status and vitamin A supplementation. A pre-designed performa was used to extract data and then analyzed later.
RESULTS: Out of 5578 children, 3317 (59.57%) were females while 2261 (40.53%) were males. Mean age of children was 24.78±14.57 months and mean weight of children was 8.67±2.45 kg. Common clinical presentations were cough (n=3036; 37.2%), fever (n=2818; 34.5%), diarrhea (n=1855; 22.7%), ear discharge (n=345; 4.2%), and sore throat (n=118; 1.4%). IMC check-signs regarding immunization status revealed full immunization in 4903 (87.9%) cases, partial immunization in 306 (5.5%) cases and no immunization/vaccination in 369 (6.6%) cases. Other check-signs included anemia (n=1592;    39.7%), mebendazole intake (n=1449; 36.1%), vitamin A intake (n=525; 13.1%) & malnutrition (n=445; 11.1%).
CONCLUSION: In our study most of the children were fully vaccinated, half of the population presented to be anaemic, and only few were malnourished. The study also revealed that about 1/3rd of the children consumed mebendazole and one by seventh of the study population had taken vitamin A.

Article Details

How to Cite
Hanif, M., S. Shaikh, M. C. Nadeem, and M. A. Shah. “SIGNIFICANCE OF INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI) CHECK SIGNS AND ITS IMPLICATION IN CHILDREN AT PAEDIATRIC OUTDOOR DEPARTMENT”. KHYBER MEDICAL UNIVERSITY JOURNAL, vol. 12, no. 2, June 2020, pp. 102-6, doi:10.35845/kmuj.2020.19128.
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Original Articles

References

Ingle GK, Chetna M. Integrated management of neonatal and childhood illness: An overview. Indian J Community Med 2007;32(2):108-10.

Rashid J, Shahid M, Bhatti T, Anwar S, Shaheen S, Jamil M. Burden of IMCI related co-existing illnesses other than diarrhea, in 2 months to 5-year age children admitted in a tertiary care unit: are we realizing the magnitude of problem? Pak J Med Health Sci 2010;4(4):495-500.

Division of Child Health and Development, World Health Organization (WHO). Improving Child health, IMCI: the integrated approach.1997. [Accessed on: February 15, 2019]. Available from URL: https://apps.who.int/iris/bitstream/handle/10665/66085/WHO_CHD_97.12_Rev.2.pdf?sequence=1.

Siddiqui MS, Siddiqui MK. Public Health Significance of Iron Deficiency Anemia. Pak Armed Forces Med J 2008;58(3):1-5

Department of Child and Adolescent Health and Development (CAH), World Health Organization (WHO). Handbook IMCI: Integrated management of neonatal and childhood illness. 2003. [Accessed on: February 15, 2019]. Available from URL: https://apps.who.int/iris/bitstream/handle/10665/42939/9241546441.pdf?sequence=1.

World Health Organization (WHO). Global Health Observatory data repository. [Accessed on: February 15, 2019]. Available from URL: http://apps.who.int/gho/data/node.main.1?lang=en

Aga Khan University, Pakistan, Pakistan Medical Research Council (PMRC), Nutrition Wing, Ministry of Health, Pakistan (Supported by: UNICEF). National Nutrition Survey 2011. [Accessed on: February 15, 2019]. Available from URL: https://www.mhinnovation.net/sites/default/files/downloads/innovation/research/Pakistan%20National%20Nutrition%20Survey%202011.pdf.

World Health Organization (WHO). Global prevalence of vitamin A deficiency in populations at risk 1995-2005: WHO global database on vitamin A deficiency.2009:p.55. [Accessed on: February 15, 2019]. Available from URL: https://apps.who.int/iris/bitstream/handle/10665/44110/9789241598019_eng.pdf?sequence=1.

United Nations Children's Fund. Malnutrition: Malnutrition prevalence remains alarming: stunting is declining too slowly while wasting still impacts the lives of far too many young children. [Accessed on: February 15, 2019]. Available from URL: https://data.unicef.org/topic/nutrition/malnutrition/.

Ahmed M, Zaidi MH, Syed S, Salikeen ZU, Shujauddin. Intestinal Parasitic Infestation among Children in Karachi. J Pak Med Assoc 1996;48(11):3913.

Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013;382(9890):427-51. DOI: 10.1016/S0140-6736(13)60937-X.

Stevens GA, Finucane MM, Paciorek CJ, Flaxman SR, White RA, Donner AJ, et al. Trends in mild, moderate, and severe stunting and underweight, and progress towards MDG 1 in 141 developing countries: a systematic analysis of population representative data. Lancet 2012;380(9844):824-34. DOI: 10.1016/S0140-6736(12)60647-3.

Chopra M, Patel S, Cloete K, Sanders D, Peterson S. Effect of an IMNCI intervention on quality of care across four districts in Cape Town, South Africa. Arch Dis Child 2005;90(4):397-401. DOI: 10.1136/adc.2004.059147.

World Health Organization (WHO). Maternal, newborn, child and adolescent health: Exploratory meeting to review new evidence for Integrated Management of Childhood Illness (IMCI) danger signs. [Accessed on: February 15, 2019]. Available from URL: https://www.who.int/maternal_child_adolescent/documents/imci-meeting-report-new-evidence/en/.

World Health Organization (WHO). e-Library of Evidence for Nutrition Actions (eLENA): Identification of severe acute malnutrition in children 6–59 months of age. [Accessed on: February 15, 2019]. Available from URL: https://www.who.int/elena/titles/sam_identification/en/.

Habib MA, Black K, Soofi SB, Hussain I, Bhatti Z, Bhutta ZA, et al. Prevalence and Predictors of Iron Deficiency Anemia in Children under Five Years of Age in Pakistan, A Secondary Analysis of National Nutrition Survey Data 2011–2012. PLoS One 2016;11(5):e0155051. DOI: 10.1371/journal.pone.0155051.

Plessow R, Arora NK, Brunner B, Tzogiou C, Eichler K, Brügger U, et al. Social costs of iron deficiency anemia in 6-59-month-old children in India. PLoS One 2015;10(8): e0136581 DOI: 10.1371/journal.pone.0136581.

Khan JR, Awan N, Misu F. Determinants of anemia among 6-59 months aged children in Bangladesh: Evidence from nationally representative data. BMC Pediatrics 2016;16(1):3(2016). DOI: 10.1186/s12887-015-0536-z.

McDonagh M, Blazina I, Dana T, Cantor A, Bougatsos C. Routine Iron Supplementation and Screening for Iron Deficiency Anemia in Children Ages 6 to 24 Months: A Systematic Review to Update the U.S. Preventive Services Task Force Recommendation. Evidence Synthesis No. Rockville, MD: Agency for Healthcare Research and Quality;2015.

Gupta PM, Perrine CG, Mei Z, Scanlon KS. Iron, Anemia, and Iron Deficiency Anemia among Young Children in the United States. Nutrients 2016;8(6):pii:E330. DOI: 10.3390/nu8060330.

Laghari ZA, Soomro AM, Tunio SA, Lashari K, Baloach FG, Baig NM, et al. Malnutrition among children under five years in District Sanghar, Sindh, Pakistan. Gomal J Med Sci 2015;13(1):54-7.

Ahsan S, Mansoori N, Mohiuddin SM, Mubeen SM, Saleem R, Irfanullah M. Frequency and determinants of malnutrition in children aged between 6 to 59 months in district Tharparkar, a rural area of Sindh. J Pak Med Assoc 2017;67(9):1369–73.

Das SK, Chisti MJ, Malek MA, Das J, Salam MA, Ahmed T, et al. Changing childhood malnutrition in Bangladesh: Trends over the last two decades in urban-rural differentials (1993-2012). Public Health Nutr 2015;18(10):1718–27. DOI: 10.1017/S136898001500004X.

Kumar S, Bhawani L. Managing child malnutrition in a drought affected district of Rajasthan A case study. Indian J Public Health 2005;49(4):198–206

Imdad A, Mayo-Wilson E, Herzer K, Bhutta, ZA. Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age. Cochrane Database Syst Rev 2017;3: CD008524. DOI: 10.1002/14651858.CD008524.pub3.

Mayo-Wilson E, Imdad A, Herzer K, Yakoob MY, Bhutta ZA. (2011). Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5: Systematic review and meta-analysis. BMJ 2011;343:d5094. DOI: 10.1136/bmj.d5094.

Wirth JP, Petry N, Tanumihardjo SA, Rogers LM, McLean E, Grieg, A, et al. Vitamin A supplementation programs and country-level evidence of vitamin A deficiency. Nutrients 2017;9(3):pii: E190 DOI: 10.3390/nu9030190.

Akhtar S, Ahmed A, Randhawa MA, Atukorala S, Arlappa N, Ismail T, et al. Prevalence of vitamin A deficiency in South Asia: Causes, outcomes, and possible remedies. J Health Popul Nutr 2013;31(4):413-23. DOI: 10.3329/jhpn.v31i4.19975.

Wasif S. The Express Tribune: Immunization coverage: Pakistan losing immunity to health disasters. [Accessed on: February 15, 2019]. Available from URL: https://tribune.com.pk/story/596647/immunisation-coveragepakistan- losing-immunity-to-health-disasters/.

World Health Organization (WHO). Suboptimal routine immunization coverage causing measles outbreaks, 2 January 2013. [Accessed on: February 15, 2019]. Available from URL: http://www.emro.who.int/pak/pakistan-news/suboptimalroutine immunization-coverage-causing-measlesoutbreaks.html.