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10/14/2017  |   1:30 PM - 2:30 PM   |  East Ballroom at Shalala Student Services Building

Integrated Management of Childhood Illness and ear infections: Knowledge and management practices of nurses in Kigali, Rwanda

Introduction Primary health facilities are the first point of contact for ill children and adults. Relying on this and considering high mortality from childhood illnesses, Integrated Management of Childhood Illness (IMCI) was introduced for implementation among developing countries. Rwanda has showed tremendous achievements in decreasing mortality in under fives through IMCI. However, high prevalence of and long standing ear infections remain a challenge to the clinician. We conducted a study to evaluate knowledge and management practices of nurses on IMCI with regards to ear infections in children under 5 in a district in Kigali, Rwanda. Methods We held 11 in depth interviews with nurses charged with IMCI at 11 health centres in a District in Kigali. All recordings were transcribed in Kinyarwanda and then translated by a lay person into English. Themes were developed deductively after which inductive approach was employed to analyse the content and to derive meanings for the observed pattern. Results All respondents had knowledge of ear infections and all related them with manifestation of symptoms presenting in the ears. No nurse was able to describe types of ear infections. Despite most of the nurses having been trained and reported following IMCI guidelines, there were discrepancies in examination where some nurses argued against using an otoscope to examine the ears. Regarding treatment, while the essential package of medicines is uniform, prescription practices differed. Conclusion While nurses are knowledgeable on signs and symptoms of ear infections, they lack uniformity in the process of making a diagnosis as well as treatment of ear infections. All health centres are expected to follow IMCI guidelines yet some health centres do not have nurses trained in IMCI and whenever they do, implementation of the guidelines differs. Refresher training on IMCI is recommended with emphasis on diagnosis and treatment of ear infections.

  • To understand the role of nurses in ear care
  • To understand the importance of tratment guidelines in ear care
  • To understand the role of continued on job training of nurses in proper ear and hearing care

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Kaitesi Mukara (POC,Primary Presenter), Kigali University Teaching Hospital, kaibat@hotmail.com;
Biography Dr. Mukara Batamuliza Kaitesi is a Rwandese Otolaryngologist and Audiologist . She is a senior Lecturer at the University of Rwanda’s College of Medicine and Health Sciences in the School of Medicine and Pharmacy. Kaitesi is the Head of ENT department, School of Medicine and Pharmacy, University of Rwanda. She is also a CARTA fellow and a DAAD scholar pursuing a PhD in Public health at Makerere University, Uganda. Her research interest is audio-otology with a bias in primary health promotion and prevention interventions as well as advocacy and policies for ear and hearing health. She holds an MSc in Audiology from the University of Southampton in the UK, a Masters of Medicine degree in Ear Nose and Throat, Head and Neck Surgery from University of Nairobi in Kenya prior to which she was awarded a degree in Human Medicine from the now University of Rwanda.

      ASHA DISCLOSURE:

Financial - No relevant financial relationship exists.

Nonfinancial - No relevant nonfinancial relationship exists.


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.

Richard Lilford (Co-Author), University of Warwick, r.j.lilford@warwick.ac.uk;
Richard Lilford has over ten years experience as Professor of Obstetrics and Gynaecology and over five years in the Department of Health. Currently he is Chair in Public Health at the University of Warwick. He additionally holds the position of Director for Warwick Centre for Applied Health Research and Delivery. Previously he was Professor of Clinical Epidemiology at the University of Birmingham, Vice-Dean for Applied Health Research and Director of the Primary Care Clinical Trials Unit. He directs the NIHR Collaboration for Leadership in Applied Health Research & Care for West Midlands (CLAHRC-WM); a NICE External Assessment Centre and is Co-Investigator on many other research grants. He also has an extensive research portfolio in Clinical Trials, Decision Analysis and Bayesian Statistics. He was a member of the Technology Strategy Board, Regenerative Medicine Mission delegation to the USA in 2010. Previous grants held include an EPSRC grant for Innovative Manufacturing: Regenerative Medicine; an EU Framework 6 grant, A Systems Approach to Tissue Engineering Processes and Products; and the Health Economic Workstream in the EPSRC Multidisciplinary Assessment of Technology Centre for Healthcare (MATCH). His greatest interest is in research methodology and Health Economics where his special expertise lies in supply side evaluations of new technology at the idea and design stages. He is Chair of the MRC/NIHR Methodology Advisory Panel and the DH Multiple Sclerosis Risk Sharing Scheme and is a NIHR Senior Investigator.
      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.

Peter Waiswa (Co-Author), Makerere University, pwaiswa@musph.ac.ug;
A medical doctor and a graduate of a Master of Public Health and the special joint PhD program between Karolinska Institutet, Sweden and Makerere University in Uganda. He extensive experience in health systems and health service management, and actively involved in community work in Uganda. He has research interests in low and middle income countries include health systems research including policy analysis, implementation and operations research, and how well these are linked to programming.
      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.

Debara Tucci MD, MS, MBA (Co-Author), Duke University, debara.tucci@duke.edu;
As a board-certified otologist/neurotologist, I am specially trained to care for adults and children with ear and hearing disorders and inner ear causes of dizziness. Some of my most rewarding work is in restoring hearing. As director of Duke’s cochlear implant program, I use cochlear implants and other surgical procedures to restore hearing in people with tumors and ear infections. My interest in hearing started when I worked as an audiologist before medical school. After joining Duke, I co-founded the Duke Hearing Center where we conduct research to one day eliminate deafness and hearing impairments.
      ASHA DISCLOSURE:

Financial - Receives Consulting fee for Consulting from Otonomy Inc.  

Nonfinancial - No relevant nonfinancial relationship exists.


      AAA DISCLOSURE:

Financial - Receives support from Otonomy Inc.