November 16, 2011
Reducing the #1 Cause of Death in Kids
(Ivanhoe Newswire) — Children treated at home for pnemonia are more likely to recover than children referred to health facilities, according to this study by Pakistan´s "Lady Health Workers".
Roughly 1.4 million children under age 5 die annually from the disease–99 percent of them in the developing world, making pnemonia the leading cause of death in childhood.
It is difficult for poor families to access quality health services, and in these communities pneumonia takes its biggest toll. Amidst a global health workforce crisis, Pakistan is one of a growing number of low-income countries to deploy community health workers to improve child and maternal health. In Pakistan, Lady Health Workers receive several months training, ongoing supervision and basic supplies and attend to about 150-200 families at home monthly.
Previous studies have shown that community health workers can successfully treat children with non-severe pneumonia at home and substantially reduce mortality rates. However, current World Health Organization (WHO) guidelines do not allow for in-home treatment when pneumonia is defined as severe (when a child's chest draws in instead of expanding during inhalation). Instead, community health workers are to administer the first dose of antibiotic and then refer a child to a facility.
Around the world, many families never make it to a health facility. Until today's publication, no rigorous randomized study had shown whether community health workers could safely and effectively treat cases of severe pneumonia at home.
"Our study aimed to show that children can recover just as well from severe pneumonia when treated at home as when referred to a health facility. In fact, we found that frontline health workers treating children at home can be even more effective," the study's principal investigator, Dr. Salim Sadruddin of Save the Children, was quoted as saying.
"The results of the Pakistan trial are very promising, and we will be looking closely at future studies. If we see similar results in other places, we can update the global guidance to make treatment much more accessible for families, help governments make the most of limited resources, and save more children's lives," Dr. Elizabeth Mason, Director of WHO's Department of Maternal, Newborn, Child and Adolescent Health, was quoted as saying.
The study followed 3,211 children with severe pneumonia in the Haripur district of Pakistan. The control group was given an initial dose of oral antibiotic and referred to a health facility. Some families did not make the trip, while others failed to receive proper treatment even after they did. The experimental group of children was treated in the community with oral antibiotics for five days by Lady Health Workers who had received additional training.
Treatment failures occurred 50 percent less often in the experimental group. After five days, 18 percent of children referred to a facility were still ill, compared to 9 percent of those treated by Lady Health Workers.
SOURCE: Lancet, published online November 10, 2011