Friday, 30 August 2019

Diagnosing Children’s Pneumonia and Other Respiratory Diseases with Ultrasound

MSF/Doctors Without Borders Study: Non-Physician Clinicians in South Sudan Diagnose Children’s Pneumonia and Other Respiratory Diseases with Ultrasound Accurately After Short Training

New research shows that non-physician clinicians in settings with health care resource shortages can learn to use point-of-care ultrasound (POCUS) to accurately diagnose pneumonia in children, according to a new study published today in the American Journal of Tropical Medicine and Hygiene.

Pneumonias are the leading cause of deaths in children under 5 years of age worldwide, particularly in low-resource settings such as Aweil, South Sudan where the study was conducted. Unfortunately, in these settings the diagnosis of pneumonia can be difficult, due to either lack of access to X-ray or overly sensitive clinical criteria. POCUS is a novel diagnostic method in which non-radiologists perform bedside ultrasounds. Lung POCUS, in particular, has been shown to improve the diagnosis of pneumonia. However, there are limited data using lung POCUS in low-resource settings.

Researchers from Médecins Sans Frontières (MSF), Icahn School of Medicine at Mount Sinai, University of Michigan School of Medicine, and the University of Washington examined the feasibility of training Clinical Officers (COs)—non-physician clinicians—in South Sudan to perform lung POCUS to differentiate among causes of lower respiratory tract disorders. Six COs underwent a brief training and subsequently each performed 60 lung POCUS studies on hospitalized pediatric patients under 5 years of age with criteria for pneumonia. Two blinded experts, with a tiebreaker expert adjudicating results, evaluated both the image quality and the CO’s interpretations. The experts rated 99.1% of the images acceptable and 86.0% of the CO interpretations appropriate. The researchers said the results of this study can be used to guide development of policies that address unmet diagnostic needs for pneumonia and thereby reduce associated medical problems and deaths in children in low resource settings.

>> Abstract

Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

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