Challenges in the diagnosis of paediatric pneumonia in intervention field trials: recommendations from a pneumonia field trial working group

Publication date: Available online 4 October 2019Source: The Lancet Respiratory MedicineAuthor(s): Dina Goodman, Mary E Crocker, Farhan Pervaiz, Eric D McCollum, Kyle Steenland, Suzanne M Simkovich, Catherine H Miele, Laura L Hammitt, Phabiola Herrera, Heather J Zar, Harry Campbell, Claudio F Lanata, John P McCracken, Lisa M Thompson, Ghislaine Rosa, Miles A Kirby, Sarada Garg, Gurusamy Thangavel, Vijayalakshmi Thanasekaraan, Kalpana BalakrishnanSummaryPneumonia is a leading killer of children younger than 5 years despite high vaccination coverage, improved nutrition, and widespread implementation of the Integrated Management of Childhood Illnesses algorithm. Assessing the effect of interventions on childhood pneumonia is challenging because the choice of case definition and surveillance approach can affect the identification of pneumonia substantially. In anticipation of an intervention trial aimed to reduce childhood pneumonia by lowering household air pollution, we created a working group to provide recommendations regarding study design and implementation. We suggest to, first, select a standard case definition that combines acute (≤14 days) respiratory symptoms and signs and general danger signs with ancillary tests (such as chest imaging and pulse oximetry) to improve pneumonia identification; second, to prioritise active hospital-based pneumonia surveillance over passive case finding or home-based surveillance to reduce the risk of non-differential misclassification ...
Source: The Lancet Respiratory Medicine - Category: Respiratory Medicine Source Type: research