The Care and Treatment of Severe Pneumonia in HIV-exposed and Infected Children in Zambia
Pneumonia is the leading cause of death in children under five worldwide according to the World Health Organization. In spite of this, it has been decades since the last major global multi-site study of the causes of pneumonia. And children globally are being treated based on research completed in the 1980s. The Pneumonia Etiology Research for Child Health (PERCH) study is a seven site study, coordinated by Johns Hopkins University, to determine the etiology, or causes, of pneumonia. With the aims of identifying the causes of pneumonia and determining if vaccines currently in development will address these causes of pneumonia in order to provide improved pneumonia care and prevention to children.
Data on the etiology of pneumonia in HIV-infected, exposed and uninfected children is expected to come from the PERCH. Preliminary data from the Zambia site for the PERCH project indicates a high mortality rate among HIV-infected and HIV-exposed children. Potentially contributing to this high mortality rate is little standardization of the care and management of pneumonia in hospitalized children by clinical staff members.
To standardize and improve the care and management of these children, a clinical algorithm (Checklist) was implemented in the Department of Pediatrics and Child Health at the University of Zambia Teaching Hospital (UTH). The algorithm, based on the WHO recommendations for the management of acute respiratory illness at referral health facilities, includes best practices for all children hospitalized with pneumonia, as well as best practices specific to HIV-infected and exposed children.
Algorithms and checklists have recently been used in critical care, anesthesia and surgical settings with demonstrated improvement in patient safety and outcomes, and have increased adherence to published guidelines leading to standardized patient care. The study will evaluate the impact of the clinical algorithm by comparing clinical outcomes before and after implementation of the Checklist within the PERCH project in Zambia.
|Principal Investigator||Donald M. Thea|
|BU Co-Investigator||Lawrence Mwananyanda|
|Dates of Research||2013|
|Donor/Funder||The Bill and Melinda Gates Foundation
Johns Hopkins University