Assembling a global database of child pneumonia studies to inform WHO pneumonia management algorithm: Methodology and applications
Martin, Helena
Falconer, Jennifer
Addo-Yobo, Emmanuel
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Aneja, Satinder
Arroyo, Luis Martinez
Asghar, Rai
Awasthi, Shally
Banajeh, Salem
Bari, Abdul
Basnet, Sudha
Bavdekar, Ashish
Bhandari, Nita
Bhatnagar, Shinjini
Bhutta, Zulfiqar A.
Brooks, Abdullah
Chadha, Mandeep
Chisaka, Noel
Chou, Monidarin
Clara, Alexey W.
Colbourn, Tim
Cutland, Clare
D'Acremont, Valerie
Echavarria, Marcela
Gentile, Angela
Gessner, Brad
Gregory, Christopher J.
Hazir, Tabish
Hibberd, Patricia L.
Hirve, Siddhivinayak
Hooli, Shubhada
Iqbal, Imran
Jeena, Prakash
Kartasasmita, Cissy B.
King, Carina
Libster, Romina
Lodha, Rakesh
Lozano, Juan M.
Lucero, Marilla
Lufesi, Norman
MacLeod, William B.
Madhi, Shabir Ahmed
Mathew, Joseph L.
Maulen-Radovan, Irene
McCollum, Eric D.
Mino, Greta
Mwansambo, Charles
Neuman, Mark, I
Nguyen, Ngoc Tuong Vy
Nunes, Marta C.
Nymadawa, Pagbajabyn
O'grady, Kerry-Ann F.
Pape, Jean-William
Paranhos-Baccala, Glaucia
Patel, Archana
Picot, Valentina Sanchez
Rakoto-Andrianarivelo, Mala
Rasmussen, Zeba
Rouzier, Vanessa
Russomando, Graciela
Ruvinsky, Raul O.
Sadruddin, Salim
Saha, Samir K.
Santosham, Mathuram
Singhi, Sunit
Soofi, Sajid
Strand, Tor A.
Sylla, Mariam
Thamthitiwat, Somsak
Thea, Donald M.
Turner, Claudia
Vanhems, Philippe
Wadhwa, Nitya
Wang, Jianwei
Zaman, Syed M. A.
Campbell, Harry
Nair, Harish
Qazi, Shamim Ahmad
Bin Nisar, Yasir
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Bin Nisar, Y (通讯作者)，World Hlth Org, Dept Maternal Newborn Child & Adolescent Hlth & A, Geneva, Switzerland.
Background The existing World Health Organiza-tion (WHO) pneumonia case management guide-lines rely on clinical symptoms and signs for identify-ing, classifying, and treating pneumonia in children up to 5 years old. We aimed to collate an individual patient-level data set from large, high-quality pre-ex-isting studies on pneumonia in children to identify a set of signs and symptoms with greater validity in the diagnosis, prognosis, and possible treatment of childhood pneumonia for the improvement of cur-rent pneumonia case management guidelines. Methods Using data from a published systematic review and expert knowledge, we identified stud-ies meeting our eligibility criteria and invited inves-tigators to share individual-level patient data. We collected data on demographic information, general medical history, and current illness episode, includ-ing history, clinical presentation, chest radiograph findings when available, treatment, and outcome. Data were gathered separately from hospital-based and community-based cases. We performed a narra-tive synthesis to describe the final data set. Results Forty-one separate data sets were includ-ed in the Pneumonia Research Partnership to Assess WHO Recommendations (PREPARE) database, 26 of which were hospital-based and 15 were commu-nity-based. The PREPARE database includes 285 839 children with pneumonia (244 323 in the hospital and 41 516 in the community), with detailed de-scriptions of clinical presentation, clinical progres-sion, and outcome. Of 9185 pneumonia-related deaths, 6836 (74%) occurred in children <1 year of age and 1317 (14%) in children aged 1-2 years. Of the 285 839 episodes, 280 998 occurred in chil-dren 0-59 months old, of which 129 584 (46%) were 2-11 months of age and 152 730 (54%) were males. Conclusions This data set could identify an improved specific, sensitive set of criteria for diagnosing clin-ical pneumonia and help identify sick children in need of referral to a higher level of care or a change of therapy. Field studies could be designed based on insights from PREPARE analyses to validate a potential revised pneumonia algorithm. The PREPARE methodology can also act as a model for disease database assembly.
