Ray Cavanaugh discusses Pakistan's recent population growth and its effects on the health of its citizens with Ahmad Rafay Alam, an environmental lawyer who lives in Lahore, Pakistan's second largest city. Furthermore, Alam identifies limitations to what we think we know about pollution and respiratory health in Pakistan. "One of the more problematic aspects of air pollution in Pakistan is that scant reliable data exists. Owing to this lack of reliable data, Alam admits he does not know how long...

'The global burden of paediatric and neonatal sepsis: a systematic review,' The Lancet Respiratory Medicine March 2018. Through this review, authors Carolin Fleischmann-Struzek, MD, David M Goldfarb, MD, Peter Schlattmann, MD, Luregn J Schlapbach, MD, Prof Konrad Reinhart, MD, and Niranjan Kissoon, MBBS uncover some important findings about the global burden and mortality of sepsis in neonates and children: "We estimate an incidence of 3·0 million cases of sepsis in neonates and 1·2 million case...

A report by researchers from the London School of Hygiene and Tropical Medicine takes a harder look at LMIC awareness of antimicrobial resistance (AMR) and knowledge of antibiotics and its impact on prescribing: "Although the healthcare professionals had a higher than expected level of knowledge about antibiotics and AMR, their prescribing practices were influenced more broadly by the high cost and limited availability of antibiotics, particularly second-line therapies, and concerns about burden...

Unitaid has released it's first-ever Fever Diagnostic Technology Landscape report! With the urgent need for both improved fever diagnosis and the preservation of antimicrobials, this report "examines a promising new generation of tough, portable tools for accurately diagnosing childhood fevers—innovations with the potential to quickly connect more children to the right treatment for their particular illness." Access the full report here . Unitaid's blog post for the report is also available here...

The Lancet Global Health, by Katherine Atkins, Stefan Flasche While the use of vaccines may decrease antimicrobial resistance burden, it is not without challenges:   "The characteristics and efficacy of a particular vaccine will influence the linked direct and indirect reductions in resistance burden and antibiotic use. Meanwhile, vaccines against non-focal pathogens (i.e. pathogens which themselves are not the targets of resistance control) might have similar and substantial benefits. Howe...

Published in BMJ, authored by Carina King, Nicholas Boyd, Isabeau Walker, Beatiwel Zadutsa, Abdullah Baqui, Salahuddin Ahmed, Mazharul Islam, Esther Kainja, Bejoy Nambiar, Iain Wilson, and Eric McCollum: Through this qualitative evaluation from Malawi and Bangladesh, researchers take a closer look at the current challenges of using pulse oximetry for management of paediatric pneumonia and how the use of pulse oximeters can be improved for low-income settings. "Making improvements to currently available oximeters and probes could further facilitate successful implementation of this technology at the community through to the hospital level for routine paediatric care. Based on these providers' varied experiences, we recommend that efforts to redesign a pulse oximeter for paediatric spot checks focus on improvements to battery durability, better fit for smaller digits and the speed at which readings are obtained." Read more about the 'end-user perceptions of opportunities, challenges and desirable design features of pulse oximeters used for paediatric pneumonia management' at http://bmjopen.bmj.com/content/8/1/e019177

By following the "razorblade model," this Rwandan company that provides cookstoves to households at no cost in exchange for customers buying their wood fuel pellets, announced at the Clean Cooking Forum in New Delhi, India, that it has raised more than $20 million in loans, grants, and the sale of carbon credits. Inyenyeri cookstoves reduce emissions by 98-99 percent compared to wood or charcoal stoves, the company says, making their stoves the highest performing (Tier 4) for indoor emissions as defined by the World Health Organization. Radha Muthiah, CEO of the Global Alliance for Clean Cookstoves: "If the Sustainable Development Goals are truly not going to leave anyone behind, we have to address this issue of clean cooking. If we are looking to ensure a world where growth is sustainable for our planet, we have to address the issue of clean cooking. If we are to engage women inclusively and equitably in all of our societies and on productive engagement, we have to address this issue of cooking ... If this issue is invested in, it can provide a transformative rate of return given how it intersects with 10 of the 17 SDGs." Find the full article at: https://www.devex.com/news/can-these-stovers-finally-crack-the-clean-cooking-problem-89537

A new blog post by Samy Ahmar, Acting Head of Health at Save the Children and Tara Brace-John, Health Advocacy Adviser is available. "Delivering quality healthcare to all Indians remains a huge challenge, given the population size and inequality in access. Despite this, we return from Delhi full of hope after witnessing first-hand what political commitment can achieve in the progress towards universal health coverage." Read the full blog post here . ​

by Dr. Mark Ansermino, University of British Columbia We use artificial intelligence (AI) almost every day. It is present in our phones, computers, cars and homes. So what about healthcare? Over the last 2-3 years there has been an increasing interest and investment in AI for healthcare, specifically through the use of smart applications. However, there are many concerns about the impact of AI. Can we trust computers to make our healthcare decisions? Will the adoption of AI result in the loss of...

A comment from the coordinator, Deep Breaths blog post by Dr. Mark Ansermino, upcoming events, and PIN member and partner updates for February 2018.  A Comment from the Coordinator Our webpage will better serve our growing membership and give you, our network members, the power to easily access important and up-to-date information about pneumonia from anywhere and at anytime. Welcome to our new webpage! Deep Breaths: Blogs from Network Members Can artificial intelligence help win the fight ...

Published in PLOS Medicine, CDDEP Director, Ramanan Laxminarayan, and coauthors in Thailand proposed the establishment of surveillance systems in low- and middle-income countries that would optimize the use of antibiotics and help combat antimicrobial resistance in the animal production sector. The authors argue that policies are needed to preserve key antibiotics for therapeutic use and to slow the spread of resistant organisms, as rising demand for meat and fish has resulted in increasingly in...

What is the effect of the Bedside Paediatric Early Warning System (BedsidePEWS) on all-cause hospital mortality and late admission to the intensive care unit (ICU), cardiac arrest, and ICU resource use? The EPOCH Randomized Clinical Trial attempts to answer this important question. Authors Christopher S. Parshuram, MBChB, DPhil, Karen Dryden-Palmer, MScN, Catherine Farrell, MD, et. al., found that "implementation of the BedsidePEWS compared with usual care did not significantly decrease all-caus...

The Every Breath Counts Coalition is a public-private partnership launched in November 2017 at UNICEF to support ten* countries to end preventable child pneumonia deaths by 2030. The Coalition will begin its work in Nigeria and has sent a formal letter of engagement to the Federal Minister of Health in partnership with the Clinton Health Access Initiative (CHAI). In preparation for a kick-off meeting in Nigeria, USAID/Dalberg is developing an assessment of Nigeria's "pneumonia con...

​ by Ginsburg AS, Lenahan JL, Izadnegahdar R, Ansermino JM ​ For diagnosing childhood pneumonia in low-resource settings, the World Health Organization sites respiratory rate measurement as a critical component in pneumonia diagnosis. However, respiratory rate is difficult to accurately measure. Through this systematic review, authors identify the need for innovative tools to better measure respiratory rate of children in low-resource settings: ​ "We searched Pubmed, Embase, and C...

Sangwei Lu, a scientist from the University of California Berkeley, has developed "NutMox," a mix of the recommended child-friendly antibiotic amoxicillin with a ready-to-eat therapeutic food allowing malnourished children being treated for pneumonia to also be treated for underlying malnutrition. The subsequent partnership with Michael Chansler from PATH has accelerated its development to market. This collaboration has been recognized as one of six winners of Johnson & Johnson's "Gen H" Cha...

by Xiaolin Wei et. al. This publication highlights the results of "one of the first rigorously designed trials on antimicrobial stewardship strategies in LMICs. Results show that the intervention package was highly effective, with significant absolute reduction in the prescribing of antibiotics for childhood upper respiratory tract infections in primary care facilities in rural China." Read the full article at: http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30383-2/fulltext?el...

by Eric D McCollum, Andrew G Smith, Michelle Eckerle, Tisungane Mvalo, Katherine L O'Brien, and Abdullah H Baqui A comment by Eric McCollum, Andrew Smith, Michelle Eckerle, Tisungane Mvalo, Katherine O'Brien, and Abdullah Baqui reviews current evidence and identifies evidence gaps for non-invasive CPAP treatment of children with pneumonia in low-resource settings. "Few treatments currently in development are as promising as CPAP, and we are optimistic about its future prospects, but key question...

by Amy Sarah Ginsburg, Keith Klugman The Lancet Global Health, November 8, 2017: 'Vaccination to reduce antimicrobial resistance' highlights the barriers to appropriate use of antibiotics in addition to identifying consequences of using antibiotics inappropriately to treat pneumonia. "Reducing the development of antimicrobial resistance is a key factor for consideration in the prevention and treatment of childhood pneumonia. Diminishing the need for antibiotics by decreasing the incidence and bu...

"Why are pneumonia and diarrhea still responsible for 1 of every 4 deaths in children under 5? [This report] explores the factors slowing progress in the most impacted countries against the world's two biggest killers of young children. It delves for the first time into the economic costs of the illnesses and sheds light on the complex relationship between childhood illnesses and poverty. Children in low-resource settings are at higher risk for illness; at the same time, pneumonia and diarrhea c...

by Shidan Tosif, Trevor Duke "SpO2 of  ≥ 94% during resuscitation may help compensate for common situations of reduced oxygen delivery. In children who do not require resuscitation or are stable post resuscitation with only lung disease, a lower limit of SpO2 for commencing oxygen of 90% will provide adequate oxygen delivery and save resources."  Click here to read the full article: https://academic.oup.com/tropej/article/63/5/402/2965636/Evidence-to-Support-Oxygen-Guidelines-for-Children