Pneumonia Innovations Network Newsletter - December 1, 2017

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Announcements

Our next Pneumonia Innovations Network webinar event will be held in January of 2018.

Mark your calendars

December 2-5, 2017
10th Congress of the World Society for Pediatric Infectious Diseases (WSPID) in Shenzhen, China

December 2, 2017

Save the Children pneumonia symposium on Pneumonia Innovations at WSPID


December 6-10, 2017

Dubai Infectious Diseases Week in Dubai, UAE

More details on these important events are listed below!

A Comment from the Coordinator


We are currently working on developing a webpage for the PIN. We hope to have the website up and running early in 2018. Keep your eyes open for details soon to come!

Pneumonia Innovations Network Member and Partner Updates

Congratulations to our network members recently inducted into the #PneumoniaFighters Class of 2017:

  • Quique Bassat (Barcelona Institute for Global Health)
  • HRH Infanta Cristina of Spain ("la Caixa" Foundation)
  • David Fleming (PATH)
  • Kristoffer Gandrup-Marino (UNICEF)
  • Keith Klugman (Bill & Melinda Gates Foundation)
  • Cammie Lee (Results for Development)
  • Carolyn Miles (Save the Children)
  • Ngozi Onwudiwe (Federal Ministry of Health, Nigeria)
  • Shamim Qazi (WHO)
  • Kate Schroder (Clinton Health Access Initiative)
Again, congratulations and thank you for your hard work!
To view the list of all 48 PneumoniaFighters, visit http://justactions.org/campaign/pneumoniafighters/


United4Oxygen releases a new video covering a public-private partnership supporting governments to increase access to pulse oximetry and oxygen beginning in Ethiopia and now expanding into Nigeria

A Clinton Global Initiative, the 20+ United4Oxygen partners support governments with national plans to increase access to both pulse oximetry and oxygen throughout their health systems. Increased access to these two neglected commodities has the potential to prevent not only newborn and child deaths from big killers like pneumonia, but also maternal deaths, and adult deaths from communicable and non-communicable diseases and traumatic injuries.A special thank you to the team at Masimo for supporting the video and to the team at Lyon for creating it.

To view this video and companion interviews with United4Oxygen leaders Stefan Swartling Peterson, Hayalnesh Tarekegn, Carolyn Miles, Kevin Watkins, Peter Moschovis, Joe Kiani, Ralph Sudfeld, and Cheri Reynolds, visit: https://vimeo.com/24228692

"Multimometer" wins Grand Challenges Canada $CDN 100K award

Grand Challenges Canada has announced a $CDN 2 million investment in 20 Canadian innovations to address persistent challenges in women's and children's health in low- and middle-income countries.Congratulations to Pneumonia Innovations Network member Israel Amirav from The University of Alberta, who received $CDN 100K for the "Multimometer," a device which simultaneously measures respiratory rate, temperature, oxygen saturation and heart rate to aid in the diagnosis of children with pneumonia and/or hypoxemia. By creating a tool to measure not only respiratory rate but also heart rate, oxygen saturation, and temperature, this device could improve the ability of community health workers to accurately recognize and treat severe respiratory diseases and reduce mortality, especially among children.Learn more about Israel Amirav's "Multimometer" at http://www.grandchallenges.ca/grantee-stars/1707-06344/

Conferences, meetings, and events

10th Congress of the World Society for Pediatric Infectious Diseases (WSPID)

Shenzhen, China. December 2-5, 2017.

View the conference schedule here: http://www.wspid2017.kenes.com/Documents/WSPID%202017%20online%20program.pdf

Registration and Group Registration available at: http://www.wspid2017.kenes.com/registration-(2)/registration#.WcFi-oWcHmI


Dubai Infectious Diseases (ID) Week

Dubai, UAE. December 6-10, 2017.

Learn more about Critical Problems and Topics like Appropriate Antibiotic prescribing by Dr. Ahmed El Beleidy.

Register to attend this conference at: https://goo.gl/XgRG7o

Articles and news

CPAP treatment for children with pneumonia in low-resource settings 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 questions must first be answered before CPAP can be broadly implemented for children with pneumonia in low-resource settings."

Read the full comment here: http://www.thelancet.com/journals/lanres/article/PIIS2213-2600(17)30347-8/fulltext

Effect of a training and educational intervention for physicians and caregivers on antibiotic prescribing for upper respiratory tract infections in children at primary care facilities in rural China: a cluster-randomised controlled trial 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?elsca1=etoc

Also see the related comment by Gary W K Wong further addressing the widespread overuse of antimicrobials and resistance to antibiotics."Since the problem of antibiotics overuse and microbial resistance is generally more severe in LMICs than in high-income countries, effective interventions to reduce antibiotic prescribing for childhood upper respiratory tract infections are urgently needed in these settings. Indiscriminate use of antibiotics for upper respiratory tract infections is widespread in China, as shown by the recent evidence that more than 90% of all mycoplasma strains isolated from different regions of China are resistant to macrolides."

Read the full comment here: http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30423-0/fulltext?elsca1=etoc


Fighting antimicrobial resistance on all fronts, The Lancet Global Health


This article is a call for everyone to play their part in mitigating the threat of antimicrobial resistance. It also emphasizes the importance of guidelines for prescribing antibiotics and the Global Action Plan on antimicrobial resistance.

"In the rural west of China, a staggering 80% of children aged between 2 and 14 years who are diagnosed with an upper respiratory tract infection (RTI) in an outpatient clinic receive a prescription for antibiotics ... The reasons for over-prescription in China are multiple, but include the need for hospitals to acquire revenue via drug sales, the demand from patients, and poor knowledge on the part of physicians."

Read the full article at: http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30432-1/fulltext?elsca1=etoc

Also be sure to view NICE guidelines on prescribing antibiotics for respiratory tract infections: (https://www.nice.org.uk/guidance/CG69/chapter/1-guidance#the-clinical-effectiveness-and-cost-effectiveness-of-antibiotic-management-strategies-for)


Global Action Plan on Antimicrobial Resistance: (http://www.who.int/antimicrobial-resistance/publications/global-action-plan/en/)


It's Time to Take the Air Out of Pneumonia by Keith Klugman

November 13, 2017: Authored by Keith Klugman, Director of Pneumonia at the Bill & Melinda Gates Foundation, this article sounds the siren for more affordable and more accessible PCV. While deaths due to pneumonia have reduced by 50% since 2000, there are still too many children who cannot access PCV. "Overall progress remains intolerably slow compared to other childhood diseases ... Approximately half of the world's children are still not receiving PCV. This leaves kids immediately vulnerable and in the longer-term impacts the effectiveness of antibiotics as more childhood infections results in increased antibiotic use."

Read the full article here: https://www.globalhealthnow.org/2017-11/its-time-take-air-out-pneumonia


Pneumococcal conjugate vaccine 13 delivered as one primary and one booster dose (1+1) compared with two primary doses and a booster (2+1) in UK infants: a multicentre, parallel group randomised controlled trial, The Lancet Infectious Diseases

This recently published study by David Goldblatt et. al. takes a closer look at dose delivery of PCV13 and compares post-booster antibody responses in (UK) infants given a PCV13 1 + 1 schedule vs. the current 2 + 1 schedule. "Our findings show that for nine of the 13 serotypes in PCV13, post-booster responses in infants primed with a single dose are equivalent or superior to those seen following the standard UK 2 + 1 schedule. Introducing a 1 + 1 schedule in countries with a mature PCV programme and established herd immunity is likely to maintain population control of vaccine-type pneumococcal disease."

Read the full article here: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30654-0/fulltext?rss=yes

Point-of-care C-reactive protein-based tuberculosis screening for people living with HIV: a diagnostic accuracy study, The Lancet Infectious Diseases


To help us achieve global targets for tuberculosis elimination, new ways to screen for tuberculosis are needed. This paper by Christina Yoon et. al. suggests that point-of-care CRP-based TB screenings should be more strongly considered by HIV/AIDS programs. "The performance characteristics of CRP support its use as a tuberculosis screening test for people living with HIV with CD4 count less than or equal to 350 cells/ μL who are initiating ART. HIV/AIDS programmes should consider point-of-care CRP-based tuberculosis screening to improve the efficiency of intensified case finding and increase uptake of tuberculosis preventive therapy."


Find the full article here: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30488-7/fulltext?elsca1=etoc


A Comment from the Chair: Leith Greenslade sheds light on the gap between the WHO's "Draft thirteenth general programme of work 2019-2023" and the latest Global Burden of Disease estimates

November 1, 2017: The World Health Organization (WHO) released their "Draft thirteenth general programme of work 2019–2023."The "Draft thirteenth general programme of work 2019–2023" document lays out the health priorities that the world's leading international governmental health agency will pursue through 2023.

Note the complete absence of the #1 killer of children and a major infectious killer of adults.We get this, "People everywhere are subject to communicable diseases (such as HIV, tuberculosis, malaria, hepatitis and neglected tropical diseases), non-communicable diseases (such as cardiovascular disease, cancer, lung disease and diabetes), complications of pregnancy and child birth, mental health disorders and the consequences of substance abuse, and injuries."Yet there is no mention of pneumonia/Lower Respiratory Infections (LRI), which kill more children than HIV, TB, malaria and NTDs combined, according to the latest Global Burden of Disease (GBD) estimates for 2016. In fact, in sub-Saharan Africa only AIDS kills more people each year than pneumonia/LRI, according to the GBD!What is the point of generating better and better cause of death data if it has no effect on organizational priorities and budgets?

Read the full WHO document here: http://apps.who.int/gb/ebwha/pdf_files/EBSS4/EBSS4_2-en.pdf?ua=1&ua=1


Immunological profiling to assess disease severity and prognosis in community-acquired pneumonia, The Lancet Respiratory Medicine

December 2017: Authored by Jesus F. Bermejo-Martin et. al., this publication looks more closely at the immunological response and what it might be able to tell us about community-acquired pneumonia cases. "Increasing evidence suggests that evaluation of a patient's immune response could help to improve severity assessment and prognosis prediction in this disease ... Large integrative studies that simultaneously evaluate innate and adaptive responses are needed to obtain further evidence on the potential clinical applications of immunological profiling in the disease."

Read the full text at: http://www.thelancet.com/journals/lanres/article/PIIS2213-2600(17)30444-7/fulltext


CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning by Pranav Rajpurkar, Jeremy Irvin, Kaylie Zhu, Brandon Yang, Hershel Mehta, Tony Duan, Daisy Ding, Aarti Bagul, Curtis Langlotz, Katie Shpanskaya, Matthew P Lungren, Andrew Y Ng

A team at Stanford University (including Andrew Ng) has just developed an algorithm that can detect pneumonia from chest X-rays at a level exceeding practicing radiologists. The algorithm, CheXNet, is a 121-layer convolutional neural network trained on ChestX-ray14, currently the largest publicly available chest X-ray dataset, containing over 100,000 frontal-view X-ray images with 14 diseases. CheXNet exceeded average radiologist performance on pneumonia detection on both sensitivity and specificity.

Both the media release ( https://qz.com/1130687/stanford-trained-ai-to-diagnose-pneumonia-better-than-a-radiologist-in-just-two-months/) and the peer-reviewed paper (https://arxiv.org/abs/1711.05225) are available.

 

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Monday, 15 July 2019