STUDY TO EVALUATE IMPACT OF REVISED(2012) WHO GUIDELINES ON PRIMARY CARE PHYSICIANS WORKING IN GOVERNMENT AND PRIVATE SECTOR ON THEIR MANAGEMENT STRATEGIES AND CHOICES OF ANTIBIOTICS IN COMMUNITY ACQUIRED PNEUMONIA IN CHILDREN AGED 2-59 MONTHS

Archana Vyas*, Javed Ahamed, Kamal K. Batar, Anusuya Gehlot, Monika Sharma, Rajesh Jangid and Akhtar Ali

ABSTRACT

Background: community acquired pneumonia continues to be the most common infectious disease and biggest killer worldwide of children under five years of age. case management is the cornerstone of pneumonia control. In 1980’s the global burden of childhood mortality due to pneumonia led WHO to develop a pneumonia control strategy suitable for countries with limited resources. The recommendations for the management of pneumonia in health facilities have recently been modified in 2012, which includes both change in classification and also change in choices of antibiotics as per recent researches. We have planned this study to evaluate how well health care professionals comply with IMCI guidelines in routine practise. Methodology: A total of 80 primary care physicians were interviewed. Data was collected through predesigned questionnaire with open ended questions prepared to sought information on knowledge, attitude and practise of participants on management of pneumonia. Results: Analysis of knowledge showed that only 16.25% participants were aware of new classification, 28.75% knew correct respiratory rate in infants, 15% identified signs of pneumonia. On analysis of attitude, 81.25% believed that all cases of ARI in children do not require antibiotics,25% believed oral antibiotics should be started on appearance of signs of pneumonia, while 16.25% would wait for danger signs to appear. Analysis of prescribing practices showed that only 35% participants were aware of recent recommended first line antibiotics according to WHO guidelines, 38.75% knew correct duration of treatment with oral antibiotics, none of the participant was aware of correct recommended dose.6.25% knew recommended first line parenteral antibiotics according to recent guidelines,32.75% used steroids for treatment of pneumonia. Conclusion: WHO policies for management of pneumonia have still not reached the grass root level and more training of health professionals is required for prompt management, timely referral and proper utilization of antibiotics and other medications.

Keywords: community acquired pneumonia, antibiotics, management.