Yé Y, Traoré C, Meissner P, Coulibaly B, Becher H, Müller O
African Population and Health Research Centre, PO Box 10787-00100, GPO, Nairobi, Kenya.
Ann Trop Med Parasitol. 2007 Jun;101(4):297-303. doi: 10.1179/136485907X176391.
The rapid and correct diagnosis of fever and anaemia at the household level is a prerequisite for the successful management and control of life-threatening disease among young children, particularly in malaria-endemic areas of Africa. The ability of mothers to diagnose fever and anaemia in their young children has recently been explored, as part of a large, birth-cohort study in rural, north-western Burkina Faso. During a cross-sectional survey in six villages, 345 children aged, <3 years and their mothers were investigated. Each mother was asked if she considered her child to be febrile and/or anaemic before that child's temperature and haematocrit were measured, with an electronic thermometer and portable centrifuge, respectively. The recorded prevalences of fever (> or =37.5 degrees C) and anaemia (haematocrit, <25%) in the children were 12.2% and 21.4%, respectively. The mothers' diagnoses had a sensitivity of 76.2% [95% confidence interval (CI)=60.6%-88.0%] for fever and 4.1% (CI=0.8%-11.4%) for anaemia, with corresponding specificities of 87.1% (CI=82.8%-90.7%) and 95.9% (CI=92.9%-98.0%). Mothers in rural Africa appear to be fairly accurate in detecting fever in their children but less accurate in detecting anaemia. While malaria control needs to employ a mix of preventive and curative measures, anaemia control will benefit from community-based malaria-control measures as well as broader approaches addressing the nutritional status of young children.
在家庭层面快速准确地诊断发热和贫血是成功管理和控制幼儿危及生命疾病的前提条件，尤其是在非洲疟疾流行地区。作为布基纳法索西北部农村一项大型出生队列研究的一部分，近期对母亲诊断幼儿发热和贫血的能力进行了探索。在六个村庄的横断面调查中，对345名3岁以下儿童及其母亲进行了调查。在分别使用电子温度计和便携式离心机测量每个孩子的体温和血细胞比容之前，询问每位母亲是否认为自己的孩子发热和/或贫血。记录的儿童发热（≥37.5℃）和贫血（血细胞比容＜25%）患病率分别为12.2%和21.4%。母亲的诊断对发热的敏感性为76.2%[95%置信区间（CI）=60.6%-88.0%]，对贫血的敏感性为4.1%（CI=0.8%-11.4%），相应的特异性分别为87.1%（CI=82.8%-90.7%）和95.9%（CI=92.9%-98.0%）。非洲农村的母亲在检测孩子发热方面似乎相当准确，但在检测贫血方面不太准确。虽然疟疾控制需要采取预防和治疗相结合的措施，但贫血控制将受益于基于社区的疟疾控制措施以及解决幼儿营养状况的更广泛方法。
