The Use of Guidelines for Lower Respiratory Tract Infections in Tanzania: A Lesson from Kilimanjaro Clinicians

B Mbwele; A Slot; Q De Mast; P Kweka; M Msuya; M Hulscher

doi:10.4103/2141-9248.181845

The Use of Guidelines for Lower Respiratory Tract Infections in Tanzania: A Lesson from Kilimanjaro Clinicians

Ann Med Health Sci Res. 2016 Mar-Apr;6(2):100-8. doi: 10.4103/2141-9248.181845.

Authors

B Mbwele¹, A Slot², Q De Mast², P Kweka³, M Msuya⁴, M Hulscher⁵

Affiliations

¹ Kilimanjaro Christian Medical Center, Kilimanjaro Clinical Research Institute, Zanzibar, Tanzania; Programme Manager - Reproductive Maternal Newborn Child Health, Nutrition and WASH, Save the Children, Zanzibar, Tanzania.
² Nijmegen Institute for International Health (NIIH, UMC Nijmegen), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
³ Vijiji International, Kilimani Tower, Mawenzi Road, Moshi, Tanzania.
⁴ Faculty of Nursing, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
⁵ Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

Abstract

Background: Evaluations of the guidelines for the management of Lower Respiratory Tract Infections (LRTI) Sub-Saharan Africa, particularly in Tanzania is scant.

Aim: The aim of the study was to assess the usefulness of the current Tanzanian treatment guideline for the management lower respiratory tract infection.

Subjects and methods: A descriptive cross sectional study in 11 hospitals of different levels in the Kilimanjaro region Data were collected from May 2012 to July 2012 by semi-structured interview for clinicians using 2 dummy cases for practical assessment. Data were analyzed by STATA v11 (StataCorp, TX, USA). Qualitative narratives from the interviews were translated, transcribed then coded by colors into meaningful themes.

Results: A variety of principles for diagnosing and managing LRTI were demonstrated by 53 clinicians of Kilimanjaro. For the awareness, 67.9% (36/53) clinicians knew their responsibility to use Standard Treatment Guideline for managing LRTI. The content derived from Standard Treatment Guideline could be cited by 11.3% of clinicians (6/53) however they all showed concern of gaps in the guideline. Previous training in the management of patients with LRTI was reported by 25.9% (14/53), majority were pulmonary TB related. Correct microorganisms causing different forms of LRTI were mentioned by 11.3% (6/53). Exact cause of Atypical pneumonia and Q fever as an example was stated by 13.0% (7/53) from whom the need of developing the guideline for LRTI was explicitly elaborated.

Conclusion: The current guidelines have not been used effectively for the management of LRTI in Tanzania. There is a need to review its content for the current practical use.

Keywords: Atypical pneumonia; Clinicians; Community acquired; Lower respiratory tract infections; Q fever; Quality of health care; Sub-Saharan Africa; Tanzania; pneumonia.