Implementation of lung ultrasound in low- to middle-income countries: a new challenge global health?

Abstract

Pneumonia remains the leading cause of death globally in children under the age of five. The poorest children are the ones most at risk of dying. In the recent years, lung ultrasound has been widely documented as a safe and easy tool for the diagnosis and monitoring of pneumonia and several other respiratory infections and diseases. During the pandemic, it played a primary role to achieve early suspicion and prediction of severe COVID-19, reducing the risk of exposure of healthcare workers to positive patients. However, innovations that can improve diagnosis and treatment allocation, saving hundreds of thousands of lives each year, are not reaching those who need them most. In this paper, we discuss advantages and limits of different tools for the diagnosis of pneumonia in low- to middle-income countries, highlighting potential benefits of a wider access to lung ultrasound in these settings and barriers to its implementation, calling international organizations to ensure the indiscriminate access, quality, and sustainability of the provision of ultrasound services in every setting. What is Known: • Pneumonia remains the leading cause of death globally in children under the age of five. The poorest children are the ones most at risk of dying. In the recent years, lung ultrasound has been widely documented as a safe and easy tool for the diagnosis and monitoring of pneumonia and several other respiratory infections and diseases. During the pandemic, it played a primary role to achieve early suspicion and prediction of severe COVID-19, reducing the risk of exposure of healthcare workers to positive patients. However, innovations that can improve diagnosis and treatment allocation, saving hundreds of thousands of lives each year, are not reaching those who need them most. What is New: • We discuss advantages and limits of different tools for the diagnosis of pneumonia in low- to middle-income countries, highlighting potential benefits of a wider access to lung ultrasound in these settings and barriers to its implementation, calling international organizations to ensure the indiscriminate access, quality, and sustainability of the provision of ultrasound services in every setting.

Respiratory Syncytial Virus and Metapneumovirus Infection Have Different Clinical Presentation in Children

“…Our data did not show any increased morbidity in female. However the demonstration of pulmonary superinfections by chest x-ray has limtations, the emergent use of lung ultrasound to diagnose pneumonia seems more sensitive [41].We found no difference in the rate of hospitalization between these 2 viruses but we observed longer hospitalization for RSV than for hMPV infection which is not in line with other studies [11,13,16,42].…”

Ten Years of Pediatric Lung Ultrasound: A Narrative Review

“…Importantly, one of the biggest advantages of LUS is its availability, especially in developing countries ( Buonsenso and De Rose, 2021 ), because it is often easier to bring the ultrasound device to children than to conduct the children to ultrasound rooms of distant hospitals. Unlike most US techniques, LUS does not require a high-tech ultrasound device: old ultrasound devices and two US probes (convex and linear) are sufficient to provide the necessary information.…”

Lung Ultrasound in Pediatrics and Neonatology: An Update

“…These advantages can be summed up to the affordability and the portability of ultrasonography that make its use feasible in low-and middle-income countries. In particular, lung ultrasonography can have a central role in the diagnosis and management of pneumonia in resource-limited settings to reduce morbidity and mortality in children [121].…”