Evidence map›Paper›PMID 33627192›Full record

ArticlePneumonia (Nathan Qld.)2021

Malawian children with fast-breathing pneumonia with and without comorbidities.

Amy Sarah Ginsburg, Tisungane Mvalo, Jun Hwang, Melda Phiri, Eric D McCollum, Madalitso Maliwichi, Robert Schmicker, Ajib Phiri, Norman Lufesi, Susanne May

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in Pneumonia (Nathan Qld.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02960919 (Prospective, Observational Study of Clinical Outcomes Among Children 2 to 59 Months of Age With Childhood Pneumonia and Other Co-morbidities in Lilongwe, Malawi Who Have Been Excluded From Pneumonia Clinical Trials), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT02960919 completednot on this map

Prospective, Observational Study of Clinical Outcomes Among Children 2 to 59 Months of Age With Childhood Pneumonia and Other Co-morbidities in Lilongwe, Malawi Who Have Been Excluded From Pneumonia Clinical Trials

TypeobservationalSponsorSave the ChildrenRan2016 to 2018Enrolled1,001ConditionsPneumoniaArmsoral amoxicillin or parenteral ampicillin/ penicillin and gentamicin, parenteral ampicillin/ penicillin, gentamicin
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Amy Sarah GinsburgUniversity of Washington Clinical Trial Center, Building 29, Suite 250, 6200 NE 74th Street, Seattle, WA, 98115, USA. messageforamy@gmail.com.
Tisungane MvaloUniversity of North Carolina Project, Lilongwe Medical Relief Fund Trust, Lilongwe, Malawi.
Jun HwangUniversity of Washington Clinical Trial Center, Building 29, Suite 250, 6200 NE 74th Street, Seattle, WA, 98115, USA.
Melda PhiriUniversity of North Carolina Project, Lilongwe Medical Relief Fund Trust, Lilongwe, Malawi.
Eric D McCollumJohns Hopkins School of Medicine, Baltimore, MD, USA.
Madalitso MaliwichiUniversity of North Carolina Project, Lilongwe Medical Relief Fund Trust, Lilongwe, Malawi.
Robert SchmickerUniversity of Washington Clinical Trial Center, Building 29, Suite 250, 6200 NE 74th Street, Seattle, WA, 98115, USA.
Ajib PhiriCollege of Medicine, University of Malawi, Blantyre, Malawi.
Norman LufesiMalawi Ministry of Health, Lilongwe, Malawi.
Susanne MayUniversity of Washington Clinical Trial Center, Building 29, Suite 250, 6200 NE 74th Street, Seattle, WA, 98115, USA.
University of Washington · USJohns Hopkins Medicine · USMinistry of Health · MWUniversity of Malawi · MW

Funding

Bill and Melinda Gates Foundation OPP1105080
6 · The paper itself

Abstract

backgroundDue to high risk of mortality, children with comorbidities are typically excluded from trials evaluating pneumonia treatment. Understanding heterogeneity of outcomes among children with pneumonia and comorbidities is critical to ensuring appropriate treatment.

methodsWe explored whether the percentage of children with fast-breathing pneumonia cured at Day 14 was lower among those with selected comorbidities enrolled in a prospective observational study than among those enrolled in a concurrent randomized controlled trial evaluating treatment with amoxicillin in Lilongwe, Malawi.

resultsAmong 79 children with fast-breathing pneumonia in the prospective observational cohort, 57 (72.2%) had HIV infection/exposure, 20 (25.3%) had malaria, 2 (2.5%) had severe acute malnutrition, and 17 (21.5%) had anemia. Treatment failure rate was slightly (not significantly) lower in children with comorbidities (4.1%, 3/73) compared to those without comorbidities (4.5%, 25/552) similarly treated. There was no significant difference in clinical cure rates by Day 14 (95.8% with vs 96.7% without comorbidity).

conclusionsChildren with fast-breathing pneumonia excluded from a concurrent clinical trial due to comorbidities did not fare worse. Children at higher risk whose caregivers seek care early and who receive appropriate risk assessment (e.g., pulse oximetry, hemoglobin, HIV/malaria testing) and treatment, can achieve clinical cure by Day 14.

trial registrationClinicalTrials.gov NCT02960919 ; registered November 8, 2016.

Indexed as

AfricaCommunity-acquired pneumoniaComorbidityFast-breathing

Identifiers

PMID33627192
PMCPMC7905626
OpenAlexW3129721963

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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.