Abstract
Background As part of a randomised controlled trial of treatment with placebo versus 3 days of amoxicillin for nonsevere fast-breathing pneumonia among Malawian children aged 2–59 months, a subset of children was hospitalised for observation. We sought to characterise the progression of fast-breathing pneumonia among children undergoing repeat assessments to better understand which children do and do not deteriorate.
Methods Vital signs and physical examination findings, including respiratory rate, arterial oxygen saturation measured by pulse oximetry (SpO2), chest indrawing and temperature were assessed every 3 h for the duration of hospitalisation. Children were assessed for treatment failure during study visits on days 1, 2, 3 and 4.
Results Hospital monitoring data from 436 children were included. While no children had SpO2 90–93% at baseline, 7.4% (16 of 215) of children receiving amoxicillin and 9.5% (21 of 221) receiving placebo developed SpO2 90–93% during monitoring. Similarly, no children had chest indrawing at enrolment, but 6.6% (14 of 215) in the amoxicillin group and 7.2% (16 of 221) in the placebo group went on to develop chest indrawing during hospitalisation.
Conclusion Repeat monitoring of children with fast-breathing pneumonia identified vital and physical examination signs not present at baseline, including SpO2 90–93% and chest indrawing. This information may support providers and policymakers in developing guidance for care of children with nonsevere pneumonia.
Abstract
This study characterised the progression of fast-breathing pneumonia among children in Malawi. Repeat monitoring of children identified vital and physical exam signs not present at baseline, including oxygen saturation of 90–93% and chest indrawing. http://bit.ly/2vUlckS
Footnotes
Conflict of interest: J. Lenahan reports grants from the Bill and Melinda Gates Foundation during the conduct of the study.
Conflict of interest: E. Nkwopara reports grants from the Bill and Melinda Gates Foundation during the conduct of the study.
Conflict of interest: M. Phiri has nothing to disclose.
Conflict of interest: T. Mvalo reports grants from the Save the Children Federation, Inc., during the conduct of the study.
Conflict of interest: M.T. Couasnon has nothing to disclose.
Conflict of interest: K. Turner has nothing to disclose.
Conflict of interest: C. Ndamala has nothing to disclose.
Conflict of interest: E.D. McCollum reports grants from the Bill and Melinda Gates Foundation outside the submitted work.
Conflict of interest: S. May reports grants from the Bill and Melinda Gates Foundation during the conduct of the study.
Conflict of interest: A.S. Ginsburg reports grants from the Bill and Melinda Gates Foundation during the conduct of the study.
Support Statement: This trial was funded by grant OPP1105080 from the Bill & Melinda Gates Foundation.
- Received October 3, 2019.
- Accepted March 4, 2020.
- Copyright ©ERS 2020
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