Journal of tropical pediatrics
-
Randomized Controlled Trial
Effectiveness of personalized written asthma action plans in the management of children with partly controlled asthma in Trinidad: a randomized controlled trial.
The provision of written asthma action plans (WAAPs) is regarded by regional and international guidelines as an essential component of patient education and self-management. However, the evidence for this practice in children is deficient. ⋯ The results of this study suggest that the provision of personalized WAAPs may play a useful role in the management of children with partly controlled asthma but is no better than standard care. Asthma education is a critical component in the prevention of exacerbations in children with partly controlled asthma.
-
Randomized Controlled Trial
Aftermath of a clinical trial: evaluating the sustainability of a medical device intervention in Ghana.
A randomized controlled trial recently demonstrated that continuous positive airway pressure (CPAP) effectively decreases respiratory rate in children presenting to Ghanaian district hospitals with respiratory distress. A follow-up study 16 months later evaluated the extent to which the skills and equipment necessary for CPAP use have been maintained. Seven of eight CPAP machines were functional, but five of eight oxygen concentrators and three of four electric generators were non-functional. ⋯ First-generation trainees scored significantly higher than second-generation trainees on both skills and knowledge assessments (p = 0.003). Appropriate technical support and training must be ensured to address equipment maintenance. Protocolization of the training program, in conjunction with skills and knowledge assessment, may improve acquisition and retention among second- and future-generation trainees.
-
To assess the effect of hypothermia on mortality of neonates with hypoxic-ischemic encephalopathy in different economic resources settings. ⋯ There is enough evidence to support hypothermia as the standard care for hypoxic-ischemic encephalopathy. Evidence from low-resource settings is limited, but hypothermia efficacy was not shown to be associated with better resources countries.
-
This study aimed to determine the prevalence of admission hypothermia (AH) among very-low-birth-weight (≤1500 g) infants in 32 Malaysian neonatal intensive care units (NICUs). This was a retrospective analysis of prospectively collected data of all very-low-birth-weight infants admitted and a questionnaire survey of the practice of AH prevention. ⋯ None of the NICUs practised complete care bundle against AH at birth (i.e. use of pre-warmed radiant warmer and cling wrap, ambient temperature of at least 25°C and use of pre-warmed transport incubator). Care bundle against neonatal hypothermia should be actively promoted in Malaysian labour rooms and operation theatres.
-
Little is known about pediatric hospital admissions in Ethiopia. ⋯ This study demonstrates a mortality pattern at our hospital that differs considerably from Ethiopia as a whole, and may differ from other hospitals in sub-Saharan Africa. Hospitals must look beyond national and regional agenda when identifying mortality reduction targets.