By Lorraine Anyango.
Establishing Effective Management for Severe Pneumonia in Children.
Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) is one of the sites where a study to compare different injectable antibiotic treatments and different modes of fluid treatment for children with severe Pneumonia is being conducted.
The study seeks to find out better ways of treating children with severe Pneumonia and to reduce the number of deaths as a result of the disease by further establishing which antibiotics are the most effective for treating children admitted with severe pneumonia.
The study will also seek to verify whether feeding through a nasogastric tube is better than giving fluids through an intravenous drip in children with severe pneumonia.
During Continuous Medical Education (CME) Dr. Teresiah Njoroge of Kemri KEMRI- Wellcome Trust said that through the study they aim to reduce the number of deaths within the first five days after enrolment.
“We seek to reduce the length of hospitalization, time taken to be able to drink and the number of deaths within 30 days after enrolment, we will also study any adverse effects that may be related to the treatments.” She added.
The treatment being studied include Antibiotics: specifically Benzyl-Penicillin + Gentamicin (Standard care) or Ceftriaxone or Amoxicillin-clavulanic acid. While the second intervention includes Feeding/fluids including IV fluids or Nasogastric tube (NGT) feeding
Pneumonia is one of the leading causes of death among young children globally. 98% of deaths occur in low- and middle-income countries. More than 10% of children admitted with severe pneumonia die while in hospital.
In the study, a total of 4392 children aged 2-59 months who have been admitted to some 12 hospitals in East Africa will be recruited.
The study will involve screening. Children will be assessed for inclusion and exclusion criteria. It will also have informed consent where permission will be obtained from the parents or guardians.
Randomization will be carried out and eligible children will be randomly assigned to one of the three antibiotics and either fluid or nasogastric tube feeding.
Clinical assessment of children will be reviewed daily in the ward up to Day 5 of admission as well as a follow-up as children will be reviewed again 30 days after admission.
JOOTRH will also benefit from the study as the staff will be trained, pediatric protocols for use will be provided, and the study will also assign two clinicians as well as a data clerk. The facility will also have injectable antibiotics which be used for the study supplied.
Periodic reports will be available, and PPEs and logistical requirements where needed will be availed. Pulse oximeters and thermometers for use in the pediatric wards will be supplied. CMEs and activities for world pneumonia days will also be supported.
This study is a collaboration between, the KEMRI-Wellcome Trust Research Programme, the Ministry of Health and participating county hospitals, Kenya Pediatric Association (through KEPRECON), the University of Nairobi, the University of Oxford, and the London School of Hygiene & Tropical Medicine.
The study has been approved by KEMRI Scientific and Ethics Review Unit and Pharmacy and Poisons Board. The study is funded by the DFID/MRC/NIHR/Wellcome Trust Joint Global Health Trials Scheme.
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