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Assembling a global database of child pneumonia studies to inform WHO pneumonia management algorithm: Methodology and applications

Martin, Helena; Falconer, Jennifer; Addo-Yobo, Emmanuel; Aneja, Satinder; Arroyo, Luis Martinez; Asghar, Rai; Awasthi, Shally; ... World Health Organization Pneumonia Research Partnership to Asse; + view all (2022) Assembling a global database of child pneumonia studies to inform WHO pneumonia management algorithm: Methodology and applications. Journal of Global Health , 12 , Article 04075. 10.7189/jogh.12.04075. Green open access

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Abstract

BACKGROUND: The existing World Health Organization (WHO) pneumonia case management guidelines rely on clinical symptoms and signs for identifying, classifying, and treating pneumonia in children up to 5 years old. We aimed to collate an individual patient-level data set from large, high-quality pre-existing studies on pneumonia in children to identify a set of signs and symptoms with greater validity in the diagnosis, prognosis, and possible treatment of childhood pneumonia for the improvement of current pneumonia case management guidelines. METHODS: Using data from a published systematic review and expert knowledge, we identified studies meeting our eligibility criteria and invited investigators to share individual-level patient data. We collected data on demographic information, general medical history, and current illness episode, including history, clinical presentation, chest radiograph findings when available, treatment, and outcome. Data were gathered separately from hospital-based and community-based cases. We performed a narrative synthesis to describe the final data set. RESULTS: Forty-one separate data sets were included in the Pneumonia Research Partnership to Assess WHO Recommendations (PREPARE) database, 26 of which were hospital-based and 15 were community-based. The PREPARE database includes 285 839 children with pneumonia (244 323 in the hospital and 41 516 in the community), with detailed descriptions of clinical presentation, clinical progression, and outcome. Of 9185 pneumonia-related deaths, 6836 (74%) occurred in children <1 year of age and 1317 (14%) in children aged 1-2 years. Of the 285 839 episodes, 280 998 occurred in children 0-59 months old, of which 129 584 (46%) were 2-11 months of age and 152 730 (54%) were males. CONCLUSIONS: This data set could identify an improved specific, sensitive set of criteria for diagnosing clinical pneumonia and help identify sick children in need of referral to a higher level of care or a change of therapy. Field studies could be designed based on insights from PREPARE analyses to validate a potential revised pneumonia algorithm. The PREPARE methodology can also act as a model for disease database assembly.

Type: Article
Title: Assembling a global database of child pneumonia studies to inform WHO pneumonia management algorithm: Methodology and applications
Location: Scotland
Open access status: An open access version is available from UCL Discovery
DOI: 10.7189/jogh.12.04075
Publisher version: http://doi.org/10.7189/jogh.12.04075
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License.
Keywords: Male, Child, Humans, Infant, Infant, Newborn, Child, Preschool, Female, Pneumonia, Case Management, World Health Organization, Algorithms, Research
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10162618
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