Conference abstract

Triaging children aged 0 - 5 years in a resource-limited primary care facility: a pilot study in Senegal

Pan African Medical Journal - Conference Proceedings. 2018:9(2).08 Dec 2018.
doi: 10.11604/pamj-cp.2018.9.2.728

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Keywords: Resource-limited triage, pediatric triage system, instrument-free triage, primary-care triage
Poster

Triaging children aged 0 - 5 years in a resource-limited primary care facility: a pilot study in Senegal

Grace Anne Turner1,&

1Nursing Department, Keur Yakaar, HLM Grand Yoff, Dakar, Senegal

&Corresponding author
Grace Anne Turner, Nursing Department, Keur Yakaar, HLM Grand Yoff, Dakar, Senegal

Abstract

Introduction: in limited-resource settings, primary care facilities often lack a triage system, delaying treatment for children aged 0 - 5 who are less likely to be recognized as urgently ill. Medical personnel lack medical equipment and training for triage, and highly infectious patients can sit for long periods in crowded waiting rooms. This study describes the adaptation of the World Health Organization’s (WHO) Emergency Triage Assessment and Treatment (ETAT) system by a large primary care clinic with limited resources in Senegal for its patients aged 0 - 5 years.

Methods: one medical and two administrative staff members were trained and given a 1-page triage guide. Screening was without medical instrumentation, limited to a brief interview and abdominal inspection. The triage system was evaluated over 5 weeks of operation, during which time data was collected on patient age, census numbers, patient wait time between arrival and consultation, and reasons for prioritization.

Results: over the evaluation period, the clinic evaluated 2,495 patients of all ages, and the triage system identified 45 priority cases, of whom 26 were aged 0 - 5 years (58%). Most young children were prioritized because of dehydration (42%), suspected measles (27%), and respiratory distress (12%). Prioritized children aged 0 - 5 years had a mean total wait time of 24 minutes (min 4, max 54), while non-priority cases had a mean total wait time of 74 minutes (min 49, max 112).

Conclusion: the system was successful in triaging patients aged 0 - 5 years, and reliably detected suspected measles cases before the patients entered the building. The abdominal inspection was shown to contribute valuable information on dehydration and work of breathing. This simple triage system without instrumentation can be used to reduce wait times for the severely ill and isolate patients with highly infectious diseases in primary care clinics with limited material and human resources.