Effect of shortened Integrated Management of Childhood Illness training on classification and treatment of under-five children seeking care in Rwanda

Figures & data

Table 1 Sociodemographic characteristics of nurses (n=121) included in this study

Demographic characteristic	Long training (n=55)	Short training (n=66)	Total (n=121)	P-value
Level of training
Registered nurse	2 (3.6%)	13 (19.7%)	15 (12.4%)	0.001
Associate nurse	53 (96.4%)	53 (80.3%)	106 (87.6%)
Sex
Male	18 (32.7%)	29 (44.0%)	47 (38.8%)	0.001
Female	37 (67.3%)	37 (56.0%)	74 (61.2%)
Age
<35 years	43 (78.2%)	55 (82.8%)	98 (81.0%)	0.168
≥35 years	12 (21.8%)	11 (17.2%)	23 (19.0%)
Length of time in the workforce
>2 years	7 (12.2%)	9 (13.7%)	16 (13.2%)	0.593
≥2 years	48 (87.8%)	57 (86.3%)	105 (86.8%)

Table 2 Appropriate classification and treatment of common under-five childhood illnesses

Outcome	Long training		Short training		P-value
	Appropriate	Total	Appropriate	Total
Classification/diagnoses
Pneumonia	247 (91.4%)	270	278 (93.0%)	299	0.513
Diarrhea	90 (74.3%)	121	94 (85.0%)	111	0.053
Fever	122 (47.4%)	257	228 (88.3%)	258	0.001
Ear infection	48 (62.0%)	78	41 (68.3%)	60	0.441
HIV	278 (72.4%)	384	291 (75.8%)	384	0.284
Malnutrition	294 (77.1%)	381	274 (71.2%)	383	0.063
Treatment/management
Pneumonia	67 (62.0%)	108	118 (89.3%)	132	0.001
Diarrhea	50 (75.7%)	66	48 (84.2%)	57	0.025
Fever (malaria)	4 (14.8%)	27	5 (29.4%)	17	0.242
Ear infection	4 (44.4%)	9	2 (33.3%)	6	0.398
Management of HIV	6 (85.7%)	7	2 (33.3%)	6	0.053
Malnutrition	24 (66.6%)	36	5 (88.3%)	6	0.414

Abbreviation: HIV, human immunodeficiency virus.

Table 3 Bivariable and multivariable logistic regression to assess the effect of short versus long training on appropriate classification and treatment of childhood illnesses

Outcomes	Short versus long training
	OR (95% CI)	aOR (95% CI)
Classification/diagnoses
Pneumonia	0.97 (0.87–1.07)	0.9 (0.88–1.09)
Diarrhea	0.9 (0.81–1.01)	0.9 (0.80–1.00)
Fever	0.7 (0.68–0.78)*	0.7 (0.64–0.75)*
Ear infection	0.9 (0.84–1.07)	0.9 (0.80–1.05)
Management of HIV	1.0 (0.98–1.09)	1.0 (0.97–1.08)
Malnutrition	1.0 (0.99–1.11)	1.0 (1.00–1.12)
Treatment/management
Pneumonia	0.8 (0.68–0.85)*	0.8 (0.70–0.89)*
Diarrhea	0.9 (0.78–1.03)	0.9 (0.78–1.07)
Fever/malaria	0.9 (0.69–1.16)	0.9 (0.65–1.16)
Ear infection	0.9 (0.62–1.30)	0.9 (0.64–1.40)
Management of HIV	1.5 (0.96–2.38)	1.2 (0.87–1.86)
Malnutrition	0.9 (0.59–1.25)	0.8 (0.49–1.29)

Notes: All multivariable analyses control for age, sex, and level of training as confounders.

* Statistical significance P<0.05.

Abbreviations: aOR, adjusted odds ratio; CI, confidence interval; HIV, human immunodeficiency virus; OR, odds ratio.