Observational studyJournal of global health2026
Assessment of childhood pneumonia management and outcomes at primary healthcare centres in Islamabad and Rawalpindi: an observational cohort study from Pakistan.
Observational study in Journal of global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Pneumonia remains a leading cause of under-five mortality in Pakistan. The Government of Pakistan adopted the revised World Health Organization guidelines, which recommend outpatient management of chest indrawing pneumonia using oral amoxicillin in children aged 2-59 months. We evaluated the management and outcomes of the guidelines at the primary healthcare (PHC) settings in Islamabad and Rawalpindi, Pakistan. Methods: We conducted a prospective observational cohort study (January 2024-February 2025) across seven PHCs. Children aged 2-59 months with cough and/or difficult breathing and chest indrawing without general danger signs, who lived in the catchment area, were enrolled following caregiver consent and followed up on day 15. The primary outcome was the case fatality rate (CFR), with secondary outcomes being caregiver-reported cure, hospitalisation, and antibiotic adherence in follow-up children. Results: Of 3358 children screened, 373 (11.1%) were diagnosed with chest indrawing pneumonia. Median age was 11 months, and 57.1% (n = 213) were male. By day 15, 366 children were successfully followed up. The CFR was 0.6% (n = 2; 95% confidence interval (CI) = 0.1-2.1), with both deaths in infants (aged 2-11 months). Caregivers reported that 89.3% (n = 327) were cured, 9.0% (n = 33) remained unchanged, and 1.1% (n = 4) worsened. Further, 12 children (3.3%) were hospitalised. At enrolment, 93.8% (n/N = 350/373) were prescribed oral antibiotics, predominantly amoxicillin (n = 322, 92.0%). Moreover, of these 350 children, 307 (87.7%) initiated treatment at home. Within this subgroup, 90.2% (n = 277) completed the prescribed course, and 89.9% (n = 249) of those completing treatment were cured. Among those who did not complete treatment, one child worsened, and another died. Conclusions: Outpatient treatment of chest indrawing pneumonia with oral amoxicillin at the PHC level is safe and effective, with low mortality and high cure rates. Strengthening Integrated Management of Childhood Illnesses protocols and supervision can reduce hospital referrals, while timely care-seeking and caregiver adherence can further improve outcomes in Pakistan and similar low-resource settings.
Indexed as
Identifiers
What OpenQuestion holds
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.