By Israel Amirav and Moran Lavie
The Lancet, July 1, 2019
One in six childhood deaths is caused by pneumonia, making it the largest infectious cause of death for children worldwide , particularly in low and middle-income countries (LMIC) where timely pneumonia diagnosis is a much greater challenge because of limited resources . The World Health Organization (WHO) defines pneumonia as the presence of fast breathing and/or chest indrawing in children who present with cough or cold and/or difficulty breathing. If diagnosed early, antibiotic therapy can be initiated to effectively treat pneumonia . Fast breathing had long been considered a sensitive clinical sign of pneumonia in a child with cough or difficulty breathing , particularly in LMIC. The WHO has recommended that community health workers (CHWs) use the respiratory rate (RR) for diagnosis and that they treat pneumonia in children according to specific case-management algorithms . There are numerous technologies for measuring RR by detecting changes in selected parameters, such as exhaled carbon dioxide, air temperature, humidity and chest wall movement [6, 7]. Each method has strengths and limitations, and most of them are not suitable for LMIC .
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