ArticleBulletin of the World Health Organization2009
Comparative impact assessment of child pneumonia interventions.
Article in Bulletin of the World Health Organization, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021.The Lancet. Infectious diseases · 2024Pooled it
- Economic Evaluations of Child Nutrition Interventions in Low- and Middle-Income Countries: Systematic Review and Quality Appraisal.Advances in nutrition (Bethesda, Md.) · 2022Pooled it
- Oxygen systems strengthening as an intervention to prevent childhood deaths due to pneumonia in low-resource settings: systematic review, meta-analysis and cost-effectiveness.BMJ global health · 2021Pooled it
- Vitamin C supplementation for prevention and treatment of pneumonia.The Cochrane database of systematic reviews · 2021Pooled it
- Vitamin C supplementation for prevention and treatment of pneumonia.The Cochrane database of systematic reviews · 2020Pooled it
- Systematic review of studies evaluating the broader economic impact of vaccination in low and middle income countries.BMC public health · 2012Pooled it
- Oral amoxicillin versus benzyl penicillin for severe pneumonia among kenyan children: a pragmatic randomized controlled noninferiority trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015Trial
- Non-COVID-19 respiratory tract infection mortality among children under 5 years old: a time series, Brazil, 2002-2022.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2026Article
- Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023.Lancet (London, England) · 2025Article
- Factors associated with childhood pneumonia and care seeking practices in Nepal: further analysis of 2019 Nepal Multiple Indicator Cluster Survey.BMC public health · 2023Article
- Cost-effectiveness and sustainability of improved hospital oxygen systems in Nigeria.BMJ global health · 2022Article
- Age Distribution of All-Cause Mortality Among Children Younger Than 5 Years in Low- and Middle-Income Countries.JAMA network open · 2022Article
- High impact health service interventions for attainment of UHC in Africa: A systematic review.PLOS global public health · 2022Article
- Pneumonia among under-five children in Alexandria, Egypt: a case-control study.The Journal of the Egyptian Public Health Association · 2020Article
- Article
- Impact of Vaccines; Health, Economic and Social Perspectives.Frontiers in microbiology · 2020Review
- Ethnic disparity in pneumonia-specific mortality among children under 5 years of age in Sichuan Province of Western China from 2010 to 2017.BMC public health · 2019Article
- Disparities by sex in care-seeking behaviors and treatment outcomes for pneumonia among children admitted to hospitals in Bangladesh.PloS one · 2019Article
- Optimizing the impact of low-efficacy influenza vaccines.Proceedings of the National Academy of Sciences of the United States of America · 2018Article
- Delays in seeking and receiving health care services for pneumonia in children under five in the Peruvian Amazon: a mixed-methods study on caregivers' perceptions.BMC health services research · 2018Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the cost-effectiveness of interventions to reduce pneumonia mortality through risk reduction, immunization and case management.
methodsCountry-specific pneumonia burden estimates and intervention costs from WHO were used to review estimates of pneumonia risk in children under 5 years of age and the efficacy of interventions (case management, pneumonia-related vaccines, improved nutrition and reduced indoor air pollution from household solid fuels). We calculated health benefits (disability-adjusted life years, DALYs, averted) and intervention costs over a period of 10 years for 40 countries, accounting for 90% of pneumonia child deaths.
findingsSolid fuel use contributes 30% (90% confidence interval: 18-44) to the burden of childhood pneumonia. Efficacious community-based treatment, promotion of exclusive breastfeeding, zinc supplementation and Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae immunization through existing programmes showed cost-effectiveness ratios of 10-60 International dollars (I$) per DALY in low-income countries and less than I$ 120 per DALY in middle-income countries. Low-emission biomass stoves and cleaner fuels may be cost-effective in low-income regions. Facility-based treatment is potentially cost-effective, with ratios of I$ 60-120 per DALY. The cost-effectiveness of community case management depends on home visit cost.
conclusionVaccines against Hib and S. pneumoniae, efficacious case management, breastfeeding promotion and zinc supplementation are cost-effective in reducing pneumonia mortality. Environmental and nutritional interventions reduce pneumonia and provide other benefits. These strategies combined may reduce total child mortality by 17%.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.