This is a submission for a Fogarty International Center K01 International Research Scientist Development Award for Dr. Eric D. McCollum, a pediatric pulmonologist at the Johns Hopkins Eudowood Division of Pediatric Respiratory Sciences. Dr. McCollum is a junior clinical investigator in the field of childhood respiratory illnesses in low-resource countries. This K01 award will provide Dr. McCollum with the support needed to achieve the following objectives: (1) to become an expert in clinical research implementation and management in Asian resource-limited settings; (2) to develop skills in advanced study design and biostatistical methods; and (3) formulate multidisciplinary, long-distance collaborations with pediatric pulmonologists. To accomplish these objectives, Dr. McCollum has crafted a mentoring team including a US primary mentor, Dr. Abdullah Baqui, Professor in the International Health Department of Johns Hopkins Bloomberg School of Public Health, an international leader of child health in low-resource Asian countries, and a Bangladesh primary mentor, Dr. Dipak Mitra, Assistant Scientist in the International Health Department of Johns Hopkins Bloomberg School of Public Health and a child health expert based in Bangladesh, as well as four co-mentors; Drs. Katherine O'Brien and Bareng Aletta Sanny Nonyane, experts in child respiratory epidemiology and analysis, respectively; and Drs. Pamela Zeitlin and William Checkley, both specialists in pulmonology. Pneumonia is the number one cause of childhood death globally as well as in Asia. Dr. McCollum's research will leverage the ongoing multicenter Pneumococcal Vaccine Impact study to evaluate pulse oximetry as a pneumonia diagnostic in the community care of rural Bangladeshi children (Aim 1) and to develop and validate a childhood respiratory illness severity score appropriate for community care in Asia (Aim 2).
In Aim 1, Dr. McCollum will lead a team of lay community health workers (CHWs) in the enrollment of 1,500 rural Bangladeshi children sick with cough and/or difficulty breathing in order to assess whether a low oxygen saturation is associated with radiographic pneumonia.
In Aim 2, Dr. McCollum will direct a team of CHWs to recruit 2,200 rural Bangladeshi children with World Health Organization-defined non-severe pneumonia in order to develop and validate a risk score predictive of oral antibiotic failure and appropriate for CHWs. The research described in this application will serve as the foundation for independent funding proposals for intervention trials using pulse oximetry in rural Asian community care programs as a diagnostic pneumonia tool and as a validated instrument to assess pneumonia severity.

Public Health Relevance

Pneumonia is the leading cause of childhood death globally; and, pneumonia care by lay community health workers reduces antibiotic treatment failure. A better understanding of pulse oximetry's role in community childhood pneumonia care by lay health workers, offers an exciting potential for improving the accuracy of pneumonia diagnosis and quality-of-care decision- making in low-resource countries.

National Institute of Health (NIH)
Fogarty International Center (FIC)
Research Scientist Development Award - Research & Training (K01)
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International and Cooperative Projects - 1 Study Section (ICP1)
Program Officer
Povlich, Laura
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Johns Hopkins University
Schools of Medicine
United States
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King, Carina; McCollum, Eric D (2018) Quality of care for paediatric admissions: is a score-based approach viable? Lancet Glob Health 6:e128-e129
Deardorff, Katrina V; McCollum, Eric D; Ginsburg, Amy Sarah (2018) Pneumonia Risk Stratification Scores for Children in Low-Resource Settings: A Systematic Literature Review. Pediatr Infect Dis J 37:743-748
King, Carina; Boyd, Nicholas; Walker, Isabeau et al. (2018) Opportunities and barriers in paediatric pulse oximetry for pneumonia in low-resource clinical settings: a qualitative evaluation from Malawi and Bangladesh. BMJ Open 8:e019177
McCollum, Eric D; Nambiar, Bejoy; Deula, Rashid et al. (2017) Impact of the 13-Valent Pneumococcal Conjugate Vaccine on Clinical and Hypoxemic Childhood Pneumonia over Three Years in Central Malawi: An Observational Study. PLoS One 12:e0168209
McCollum, Eric D; Park, Daniel E; Watson, Nora L et al. (2017) Listening panel agreement and characteristics of lung sounds digitally recorded from children aged 1-59 months enrolled in the Pneumonia Etiology Research for Child Health (PERCH) case-control study. BMJ Open Respir Res 4:e000193
McCollum, Eric D; Smith, Andrew G; Eckerle, Michelle et al. (2017) CPAP treatment for children with pneumonia in low-resource settings. Lancet Respir Med 5:924-925
Mahomed, Nasreen; Fancourt, Nicholas; de Campo, John et al. (2017) Preliminary report from the World Health Organisation Chest Radiography in Epidemiological Studies project. Pediatr Radiol 47:1399-1404
McCollum, Eric D; Ginsburg, Amy Sarah (2017) Outpatient Management of Children With World Health Organization Chest Indrawing Pneumonia: Implementation Risks and Proposed Solutions. Clin Infect Dis 65:1560-1564
Hooli, Shubhada; Colbourn, Tim; Lufesi, Norman et al. (2016) Predicting Hospitalised Paediatric Pneumonia Mortality Risk: An External Validation of RISC and mRISC, and Local Tool Development (RISC-Malawi) from Malawi. PLoS One 11:e0168126
McCollum, Eric D; King, Carina; Hammitt, Laura L et al. (2016) Reduction of childhood pneumonia mortality in the Sustainable Development era. Lancet Respir Med 4:932-933

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