Publication
Title
Effect of integrated infectious disease training and on-site support on the management of childhood illnesses in Uganda : a cluster randomized trial
Author
Abstract
Background: The Integrated Infectious Disease Capacity-Building Evaluation (IDCAP) was designed to test the effects of two interventions, Integrated Management of Infectious Disease (IMID) training and on-site support (OSS), on clinical practice of mid-level practitioners. This article reports the effects of these interventions on clinical practice in management of common childhood illnesses. Methods: Two trainees from each of 36 health facilities participated in the IMID training. IMID was a three-week core course, two one-week boost courses, and distance learning over nine months. Eighteen of the 36 health facilities were then randomly assigned to arm A, and participated in OSS, while the other 18 health facilities assigned to arm B did not. Clinical faculty assessed trainee practice on clinical practice of six sets of tasks: patient history, physical examination, laboratory tests, diagnosis, treatment, and patient/caregiver education. The effects of IMID were measured by the post/pre adjusted relative risk (aRR) of appropriate practice in arm B. The incremental effects of OSS were measured by the adjusted ratio of relative risks (aRRR) in arm A compared to arm B. All hypotheses were tested at a 5 % level of significance. Results: Patient samples were comparable across arms at baseline and endline. The majority of children were aged under five years; 84 % at baseline and 97 % at endline. The effects of IMID on patient history (aRR = 1.12; 95 % CI = 1.04-1.21) and physical examination (aRR = 1.40; 95 % CI = 1.16-1.68) tasks were statistically significant. OSS was associated with incremental improvement in patient history (aRRR = 1.18; 95 % CI = 1.06-1.31), and physical examination (aRRR = 1.27; 95 % CI = 1.02-1.59) tasks. Improvements in laboratory testing, diagnosis, treatment, and patient/caregiver education were not statistically significant. Conclusion: IMID training was associated with improved patient history taking and physical examination, and OSS further improved these clinical practices. On-site training and continuous quality improvement activities support transfer of learning to practice among mid-level practitioners.
Language
English
Source (journal)
BMC pediatrics. - London
Publication
London : 2015
ISSN
1471-2431
Volume/pages
15(2015), 14 p.
Article Reference
103
ISI
000360275600001
Medium
E-only publicatie
Full text (Publishers DOI)
Full text (open access)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 05.10.2015
Last edited 01.04.2017
To cite this reference