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

Helena Martin, Jennifer Falconer, Emmanuel Addo-Yobo, Satinder Aneja, Luis Martinez Arroyo, Rai Asghar, Shally Awasthi, Salem Banajeh, Abdul Bari, Sudha Basnet, Ashish Bavdekar, Nita Bhandari, Shinjini Bhatnagar, Zulfiqar A. Bhutta, Abdullah Brooks, Mandeep Chadha, Noel Chisaka, Monidarin Chou, Alexey W. Clara, Tim ColbournClare Cutland, Valérie D’Acremont, Marcela Echavarria, Angela Gentile, Brad Gessner, Christopher J. Gregory, Tabish Hazir, Patricia L. Hibberd, Siddhivinayak Hirve, Shubhada Hooli, Imran Iqbal, Prakash Jeena, Cissy B. Kartasasmita, Carina King, Romina Libster, Rakesh Lodha, Juan M. Lozano, Marilla Lucero, Norman Lufesi, William B. MacLeod, Shabir Ahmed Madhi, Joseph L. Mathew, Irene Maulen-Radovan, Eric D. McCollum, Greta Mino, Charles Mwansambo, Mark I. Neuman, Ngoc Tuong Vy Nguyen, Marta C. Nunes, Pagbajabyn Nymadawa, Kerry Ann F. O’Grady, Jean William Pape, Glaucia Paranhos-Baccala, Archana Patel, Valentina Sanchez Picot, Mala Rakoto-Andrianarivelo, Zeba Rasmussen, Vanessa Rouzier, Graciela Russomando, Raul O. Ruvinsky, Salim Sadruddin, Samir K. Saha, Mathuram Santosham, Sunit Singhi, Sajid Soofi, Tor A. Strand, Mariam Sylla, Somsak Thamthitiwat, Donald M. Thea, Claudia Turner, Philippe Vanhems, Nitya Wadhwa, Jianwei Wang, Syed M.A. Zaman, Harry Campbell, Harish Nair, Shamim Ahmad Qazi, Yasir Bin Nisar

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

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.

Original languageEnglish
Article number04075
JournalJournal of Global Health
Volume12
DOIs
Publication statusPublished - 2022

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