ArticleBMJ open2021
Aetiology and severity of childhood pneumonia in primary care in Malawi: a cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Trial
- Prediction of hospitalisation in young children with pneumonia in Malawi: A machine learning-based approach.PLoS medicine · 2026Article
- Respiratory syncytial virus-associated pneumonia in primary care in Malawi.Journal of tropical pediatrics · 2024Article
- Design of a Trustworthy Cloud-Native National Digital Health Information Infrastructure for Secure Data Management and Use.Oxford open digital health · 2024Article
- Does procalcitonin have clinical utility in the management of paediatric community-acquired pneumonia? A PRO/CON debate.JAC-antimicrobial resistance · 2021Review
- A Systematic Review of Clinical Prediction Rules to Predict Hospitalisation in Children with Lower Respiratory Infection in Primary Care and their Validation in a New Cohort.EClinicalMedicine · 2021Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the aetiology of community acquired pneumonia in children presenting to primary care in Northern Malawi, and to ascertain predictors for identification of children requiring hospitalisation.
designThe BIOmarkers TO diagnose PnEumonia study was a prospective cohort study conducted from March to June 2016.
settingPrimary care in Northern Malawi. PATIENTS: 494 children aged 2 -59 months with WHO defined pneumonia. MAIN OUTCOMES AND MEASURES: Number of children with bacterial infection identified and the sensitivity/specificity of WHO markers of severity for need for hospitalisation.
results13 (2.6%) children had a bacterium consistent with pneumonia identified. A virus consistent with pneumonia was identified in in 448 (90.7%) of children. 56 children were admitted to hospital and two children died within 30 days. 442 (89.5%) received antibiotic therapy. Eleven children (2.6%) had HIV. WHO severity markers at baseline demonstrated poor sensitivity for the need for hospitalisation with a sensitivity of 0.303 (95% CI 0.188 to 0.441) and a specificity 0.9 (95% CI 0.868 to 0.926). A prediction rule to indicate the need for hospitalisation was developed. CONCLUSIONS AND RELEVANCE: The low rate of bacterial infection and high use of antibiotics in the setting of high immunisation rates highlights the changing profile of childhood pneumonia. Similarly, the markers of need for hospitalisation may have changed in the setting of extended immunisation. Further studies are required to examine this.
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