Delayed care seeking for fatal pneumonia in children aged under five years in Uganda: a case-series study

This research paper in the Bulletin of the World Health Organization reviews individual case histories of children who have died of pneumonia in rural Uganda and investigates why these children did not survive. The research was conducted in the Lganga/Mayuge region in Uganda where 67,000 people were visited once every three months for population-based data. Children aged 1-59 months from November 2005 to August 2007 were included in the study.

The paper finds that of the pneumonia deaths that were registered, half occurred in hospital and one-third at home. Median duration of pneumonia illness was seven days, and median time taken to seek care outside the home was two days. Most children first received drugs at home: 52 per cent antimalarials and 27 per cent antibiotics. The paper concludes that many children with fatal pneumonia experienced mistreatment with antimalarials, delays in seeking care and low quality of care. To improve access to and quality of care, the feasibility and effectiveness of training community health workers and drug vendors in pneumonia and malaria management with prepacked drugs should be tested. [adapted from authors]