Randomized Controlled Trial of Day Care Versus Hospital Care of Severe Pneumonia in Bangladesh

Abstract

Severe childhood pneumonia without severe malnutrition can be successfully managed at day care clinics, except for children with hypoxemia who require prolonged oxygen therapy.

Clinical care for severe influenza and other severe illness in resource‐limited settings: the need for evidence and guidelines

“…Similarly, in a pediatric outpatient and emergency unit in Malawi, directed trainings based on IMCI to improve triage and emergency care resulted in streamlined healthcare delivery and a 10% decrease in pediatric in‐hospital mortality . Modifications of IMCI have also been shown to improve pneumonia outcomes when implemented in the community setting . Moreover, economic analyses have found IMCI protocolized care to be cost effective and comparable to preventive interventions such as routine childhood pneumococcal conjugate immunization .…”

Acute respiratory infection and pneumonia in India: A systematic review of literature for advocacy and action: UNICEF-PHFI series on newborn and child health, India

“…In a recent trial in Bangladesh [56], children (2-59 months old) with severe pneumonia (WHO criteria) but without severe malnutrition and/or other complications, were randomized to be treated with injectable ceftriaxone either as 'day-care' or hospitalized. After treatment, both groups had comparable duration of symptoms, oxygen therapy and duration of stay; suggesting that severe pneumonia without malnutrition could be managed as day-care without admission.…”

Pneumonia

“…Most children with CAP can be treated with oral therapy (Addo-Yobo et al, 2004). WHO recommends home care for cases that are not 'severe' including those with chest indrawing, though randomized trial evidence for the safe home treatment of pneumonia with chest indrawing is largely from South Asia (Ashraf et al, 2010;Hazir et al, 2008) and further evidence from elsewhere, notably Africa, would be beneficial.…”