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Table 3 Proportion of all records and proportion of records from children admitted with major, common diseases in which clinical features of particular relevance were recorded in the pre-intervention and the four post-intervention periods. The Kenyan Acute Respiratory Infection (ARI) and Control of Diarrhoeal Diseases (CDD) Programmes (now merged in the IMCI programme) have been in place promoting use of WHO case management for more than 10 years. New National Malaria Control Programme guidelines were disseminated in 1998

From: Implementation of a structured paediatric admission record for district hospitals in Kenya – results of a pilot study

All records Kenyan programme (Duration) Pre-intervention (%) Post intervention periods (%)
    One Two Three Four
Weight   47 22 24 32 41
Record of DTP-HepB-HiB vaccination   1 45 33 32 31
History of Fever Malaria (6 yrs)   77 82 79 81
History of Convulsions Malaria, (6 yrs) 20 51 72 70 75
History of Cough ARI/IMCI (>10 yrs) 53 70 77 73 66
History of Difficulty Breathing ARI/IMCI (>10 yrs) 37 62 75 70 69
History of Diarrhoea CDD/IMCI (>10 yrs) 43 58 74 73 72
History of Diarrhoea > two weeks CDD/IMCI (>10 yrs) 22 48 69 67 59
History of vomiting everything - 6 47 67 68 71
Conscious level – AVPU classification -   42 78 65 67
Ability to Drink Malaria (6 yrs) 3 41 67 66 75
Stiff Neck - 45 42 69 65 72
Presence of Visible Severe Wasting - 3 41 68 66 64
Bilateral Oedema of Kwashiorkor - 31 55 74 71 65
Respiratory Rate ARI/IMCI (>10 yrs)   64 56 53 59
Lower chest wall indrawing ARI/IMCI (>10 yrs) 43 49 67 68 67
Cyanosis ARI/IMCI (>10 yrs) 36 56 75 73 73
Grunting - 13 42 69 65 68
Acidotic/Deep breathing Malaria (6 yrs) 3 41 65 64 57
Wheeze   16 36 67 63 57
Sunken Eyes CDD/IMCI (>10 yrs) 5 43 67 66 58
Skin pinch (skin turgor) CDD/IMCI (>10 yrs) 3 41 65 65 53
Records of malaria cases       
Conscious level – AVPU classification   - 42 79 74 80
Acidotic/Deep breathing Malaria (6 yrs) 2 44 77 80 78
Records of Dehydration/diarrhoea cases       
Sunken Eyes CDD/IMCI (>10 yrs) 2 60 83 90 83
Skin pinch (skin turgor) CDD/IMCI (>10 yrs) 7 60 86 92 83
Records of ARI/Pneumonia cases       
Lower chest wall indrawing ARI/IMCI (>10 yrs) 33 69 85 87 91
Ability to Drink ARI/IMCI (>10 yrs) 4 53 85 85 100