Assessing the quality of the management skills required for lower respiratory tract infections in Kilimanjaro, Tanzania

Background: Lower respiratory tract infections (LRTI) are among the leading causes of morbidity and mortality. A severe form of atypical pneumonia, Q fever, has been found in Northern Tanzania. Assessment of the quality of health care for lower respiratory tract infection from the clinicians performance has rarely been performed. Methods: A cross sectional descriptive study using the qualitative and quantitative approaches in 11 hospitals of different levels in Kilimanjaro region. Clinicians of the Health facilities and patients files were assessed. Results: Medications for LRTI were highly variable for both the first and second attempts. No file showed attempts for assessing the severity of Pneumonia. No documentation of atypical pneumonia could be found from files. Clinicians are not aware of the causes of atypical pneumonia and how to treat it. Only 6 (11.1%) clinicians could mention causes of atypical pneumonia. Only 7 clinicians (13.0%) clinicians were aware of Q-fever and could mention the cause of Q-fever. Clinical records for monitoring the progress were varying significantly by levels of care. Level of mental state χ (4) = 139.4; P value < 0.001, blood pressure χ (8) = 75.2; P value < 0.001, temperature χ (4) = 78.7; P value < 0.001, pulse rate χ (4) = 139.1; P value < 0.001, respiratory rate χ (4) = 197.7; P value < 0.001, auscultation χ (4) = 92.2; P value < 0.001. Conclusion: Management of LRTI and atypical pneumonia shall be guided by the local audits reflected by the scientific reports.