Traditionally, pneumonia in children is treated by oral amoxicillin in hospital facilities. Community-level health workers are not allowed to treat these children when presented at the community level. However, with the increasing patient load in the hospitals, clinicians are looking at ways to treat these patients in the community outside of hospital premises.
A clinical trial explores the safety and effectiveness of treating children 2-59 months old with chest indrawing pneumonia with a 5-day course of oral amoxicillin at the community level.
Chest-indrawing pneumonia is a type of pneumonia that affects children between the ages of 2 and 59 months. It is a severe respiratory infection that causes the chest to cave inwards while breathing. This type of pneumonia can be fatal if not treated promptly, and it is a significant cause of childhood morbidity and mortality, particularly in developing countries. Up till now the World Health Organization has recommended in-hospital treatment of all such cases, however, recently there has been a paradigm shift and physicians are now exploring out-of-hospital management of these cases especially when a referral is not feasible.
Clinical Trial
The EMPIC Study Group has conducted an innovative clinical trial for non-hypoxaemic chest-indrawing pneumonia in children. The trial aimed to test whether an enhanced community management approach could reduce the morbidity and mortality rates in these patients.The clinical study involved 62,363 patients across four countries. Children aged 2-59 months having parents/caregivers reported cough and/or difficult breathing presenting to a community health worker were screened for enrolment in the clinical trial. The patients were divided into two groups: an intervention group and a control group.
The intervention group received enhanced community management, which included the administration of oral amoxicillin two times a day for 5 days. In contrast, the patients in the control group received the standard treatment and were referred to a nearby health facility.
The results of the clinical study showed that 4.3% of the patients in the intervention group failed treatment compared to 4.4% of patients in the control group. 5 deaths were reported in each group. These results indicate that the treatment failure rates and hence the success rates were similar in both groups which shows that the enhanced community management approach was as effective as traditional management in reducing the morbidity and mortality rates of non-hypoxaemic chest-indrawing pneumonia in children.
The clinical trial's results indicate that the enhanced community management approach is a promising strategy for reducing the burden of chest-indrawing pneumonia in children. This approach could be scaled up and integrated into existing health systems to improve the care and outcomes of children with this condition.
Conclusion
The EMPIC Study Group's innovative, enhanced community management approach for pneumonia in children has shown promising results. This is significant as it reduces the burden on healthcare facilities and simultaneously improves the overall health outcomes of children suffering from pneumonia.__________
BMJ Global Health Journal, Jan-05-22