ArticlePloS one2014
Reducing deaths from severe pneumonia in children in Malawi by improving delivery of pneumonia case management.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- What are the risk factors for death among children with pneumonia in low- and middle-income countries? A systematic review.Journal of global health · 2023Pooled it
- Quality of care for children with acute respiratory infections in health facilities: a comparative analysis of assessment tools.Journal of global health · 2022Pooled it
- Trial
- Oxygen systems to improve clinical care and outcomes for children and neonates: A stepped-wedge cluster-randomised trial in Nigeria.PLoS medicine · 2019Trial
- "A child with severe pneumonia cannot feed, causing malnutrition": exploring health worker and caregiver perspectives and practices for mitigating malnutrition among children with severe pneumonia, a case of Uganda.BMC health services research · 2025Article
- Improving adherence to severe malaria treatment guidelines in children at a Ugandan regional hospital: assessment of a quality improvement initiative.Malaria journal · 2024Article
- Provider adherence to clinical care recommendations for infants and children who died in seven low- and middle-income countries in the Child Health and Mortality Prevention Surveillance (CHAMPS) network.EClinicalMedicine · 2023Article
- Cost-effectiveness and sustainability of improved hospital oxygen systems in Nigeria.BMJ global health · 2022Article
- Situational Analysis of Management of Childhood Diarrhea and Pneumonia in 13 District Hospitals in India.Indian pediatrics · 2021Article
- Social determinants of deaths from pneumonia and tuberculosis in children in Brazil: an ecological study.BMJ open · 2020Article
- Decreased number of hospitalized children with severe acute lower respiratory infection after introduction of the pneumococcal conjugate vaccine in the Eastern Democratic Republic of the Congo.The Pan African medical journal · 2020Article
- Bacterial pneumonia and its associated factors in children from a developing country: A prospective cohort study.PloS one · 2020Article
- Impact of the change in WHO's severe pneumonia case definition on hospitalized pneumonia epidemiology: case studies from six countries.Bulletin of the World Health Organization · 2019Observational
- A mixed method multi-country assessment of barriers to implementing pediatric inpatient care guidelines.PloS one · 2019Article
- Content of Care in 15,000 Sick Child Consultations in Nine Lower-Income Countries.Health services research · 2018Article
- Some sustained improvements in pneumonia case management four and five years following implementation of paediatric hospital guidelines in Lao PDR.Scientific reports · 2017Article
- Bubble continuous positive airway pressure in the treatment of severe paediatric pneumonia in Malawi: a cost-effectiveness analysis.BMJ open · 2017Article
- Mortality after Inpatient Treatment for Severe Pneumonia in Children: a Cohort Study.Paediatric and perinatal epidemiology · 2017Observational
- Providing oxygen to children in hospitals: a realist review.Bulletin of the World Health Organization · 2017Review
- A model for oxygen conservation associated with titration during pediatric oxygen therapy.PloS one · 2017Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the pneumonia specific case fatality rate over time following the implementation of a Child Lung Health Programme (CLHP) within the existing government health services in Malawi to improve delivery of pneumonia case management.
methodsA prospective, nationwide public health intervention was studied to evaluate the impact on pneumonia specific case fatality rate (CFR) in infants and young children (0 to 59 months of age) following the implementation of the CLHP. The implementation was step-wise from October 1st 2000 until 31st December 2005 within paediatric inpatient wards in 24 of 25 district hospitals in Malawi. Data analysis compared recorded outcomes in the first three months of the intervention (the control period) to the period after that, looking at trend over time and variation by calendar month, age group, severity of disease and region of the country. The analysis was repeated standardizing the follow-up period by using only the first 15 months after implementation at each district hospital.
findingsFollowing implementation, 47,228 children were admitted to hospital for severe/very severe pneumonia with an overall CFR of 9.8%. In both analyses, the highest CFR was in the children 2 to 11 months, and those with very severe pneumonia. The majority (64%) of cases, 2-59 months, had severe pneumonia. In this group there was a significant effect of the intervention Odds Ratio (OR) 0.70 (95%CI: 0.50-0.98); p = 0.036), while in the same age group children treated for very severe pneumonia there was no interventional benefit (OR 0.97 (95%CI: 0.72-1.30); p = 0.8). No benefit was observed for neonates (OR 0.83 (95%CI: 0.56-1.22); p = 0.335).
conclusionsThe nationwide implementation of the CLHP significantly reduced CFR in Malawian infants and children (2-59 months) treated for severe pneumonia. Reasons for the lack of benefit for neonates, infants and children with very severe pneumonia requires further research.
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