Bubble continuous positive airway pressure for children with high-risk conditions and severe pneumonia in Malawi: an open label, randomised, controlled trial

By Eric D McCollum, Tisungane Mvalo, Michelle Eckerle, Andrew G Smith, Davie Kondowe, Don Makonokaya, Dhananjay Vaidya, Veena Billioux, Alfred Chalira, Norman Lufesi, Innocent Mofolo, and Mina Hosseinipour.

The Lancet, Respiratory Medicine, November 2019

There were almost 1 million deaths in children aged between 5 and 14 years in 2017, and pneumonia accounted for 11%. However, there are no validated guidelines for pneumonia management in older children and data to support their development are limited. We sought to understand risk factors for mortality among children aged 5–14 years hospitalised with pneumonia in district-level health facilities in Kenya.

We did a retrospective cohort study using data collected from an established clinical information network of 13 hospitals. We reviewed records for children aged 5–14 years admitted with pneumonia between 1 March 2014 and 28 February 2018. Individual clinical signs were examined for association with inpatient mortality using logistic regression. We used existing WHO criteria (intended for under 5s) to define levels of severity and examined their performance in identifying those at increased risk of death.


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Sunday, 23 February 2020