Tufts University School of Medicine and the Indira Gandhi Government Medical College Nagpur, India, affiliated with Lata Medical Research Foundation, are proposing to expand their longstanding multidisciplinary collaboration and partnership in the study of childhood pneumonia and are applying to participate in the Global Network for Women's and Children's Health Research. The goal of this participation is to improve scientific knowledge and outcomes in neonates and young children and to expand capacity and infrastructure in the research unit at Nagpur, India. Their proposal for the Global Network application focuses on childhood pneumonia. Every year, at least 2 million children under age 5 die of pneumonia - more than the number of children who die of AIDS, malaria and measles combined. Mortality is highest in children who are hypoxemicor infected with HIV, where mortality rates are as high as 80%. Hypoxemia has long been recognized as an important predictor of mortality and poor outcome in childhood pneumonia. The World Health Organization's case-management strategy uses woefully inadequate clinical signs to detect hypoxemia, missing about 30% of children who are hypoxemic. These children do not receive much needed oxygen therapy and bear the brunt of adverse outcomes. Investment in pulse oximetry to detect hypoxemia in rural and district hospitals worldwide has not occurred, partly because no clinical trial has been conducted to determine whether access to pulse oximetry is either life-saving or cost-effective. We propose that Global Network sites conduct a cluster randomized trial to evaluate whether access to pulse oximetry and training providers in its use to guide oxygen therapy decreases treatment failure and mortality in children with pneumonia. The study will be conducted in rural hospitals that currently have no access to pulse oximetry. We will assess whether this approach is cost effective. We will also determine the microbiologic predictors of treatment failure and mortality in the eras of HIV infection and increasing antimicrobial resistance, as the etiology of pneumonia in the community setting in developing countries has not been studied since the 1980s. Introduction of pulse oximetry is a simple, easy to use, inexpensive and highly relevant technology that has the potential to improve outcomes, in a sustainable way, for one of the most pressing global health problems - childhood pneumonia.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01HD058322-02
Application #
7641067
Study Section
Special Emphasis Panel (ZHD1-DSR-K (16))
Program Officer
Wright, Linda
Project Start
2008-06-17
Project End
2010-04-30
Budget Start
2009-05-01
Budget End
2010-04-30
Support Year
2
Fiscal Year
2009
Total Cost
$646,324
Indirect Cost
Name
Tufts University
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
039318308
City
Boston
State
MA
Country
United States
Zip Code
02111
Pasha, O; McClure, E M; Saleem, S et al. (2018) A prospective cause of death classification system for maternal deaths in low and middle-income countries: results from the Global Network Maternal Newborn Health Registry. BJOG 125:1137-1143
McClure, E M; Garces, A; Saleem, S et al. (2018) Global Network for Women's and Children's Health Research: probable causes of stillbirth in low- and middle-income countries using a prospectively defined classification system. BJOG 125:131-138
Patel, Archana; Prakash, Amber Abhijeet; Das, Prabir Kumar et al. (2018) Maternal anemia and underweight as determinants of pregnancy outcomes: cohort study in eastern rural Maharashtra, India. BMJ Open 8:e021623
Patel, Archana; Prakash, Amber Abhijeet; Pusdekar, Yamini V et al. (2017) Detection and risk stratification of women at high risk of preterm birth in rural communities near Nagpur, India. BMC Pregnancy Childbirth 17:311
Goldenberg, Robert L; Saleem, Sarah; Ali, Sumera et al. (2017) Maternal near miss in low-resource areas. Int J Gynaecol Obstet 138:347-355
Patel, Archana B; Prakash, Amber Abhijeet; Raynes-Greenow, Camille et al. (2017) Description of inter-institutional referrals after admission for labor and delivery: a prospective population based cohort study in rural Maharashtra, India. BMC Health Serv Res 17:360
Harrison, Margo S; Pasha, Omrana; Saleem, Sarah et al. (2017) A prospective study of maternal, fetal and neonatal outcomes in the setting of cesarean section in low- and middle-income countries. Acta Obstet Gynecol Scand 96:410-420
Garces, Ana L; McClure, Elizabeth M; PĂ©rez, Wilton et al. (2017) The Global Network Neonatal Cause of Death algorithm for low-resource settings. Acta Paediatr 106:904-911
Bang, Akash; Patel, Archana; Bellad, Roopa et al. (2016) Helping Babies Breathe (HBB) training: What happens to knowledge and skills over time? BMC Pregnancy Childbirth 16:364
Bellad, Roopa M; Bang, Akash; Carlo, Waldemar A et al. (2016) A pre-post study of a multi-country scale up of resuscitation training of facility birth attendants: does Helping Babies Breathe training save lives? BMC Pregnancy Childbirth 16:222

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