RT Journal Article
SR Electronic
T1 Pulse oximeter with integrated management of childhood illness for diagnosis of severe childhood pneumonia at rural health institutions in Southern Ethiopia: results from a cluster-randomised controlled trial
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e036814
DO 10.1136/bmjopen-2020-036814
VO 10
IS 6
A1 Solomon H Tesfaye
A1 Yabibal Gebeyehu
A1 Eskindir Loha
A1 Kjell Arne Johansson
A1 Bernt Lindtjørn
YR 2020
UL http://bmjopen.bmj.com/content/10/6/e036814.abstract
AB Objective To assess whether pulse oximetry improves health workers’ performance in diagnosing severe childhood pneumonia at health centres in Southern Ethiopia.Design Parallel cluster-randomised trial.Setting Government primary health centres.Participants Twenty-four health centres that treat at least one pneumonia case per day in Southern Ethiopia. Children aged between 2 months and 59 months who present at health facilities with cough or difficulty breathing were recruited in the study from September 2018 to April 2019.Intervention arm Use of the Integrated Management of Childhood Illness (IMCI) algorithm and pulse oximeter.Control arm Use of the IMCI algorithm only.Primary and secondary outcome measures The primary outcome was the proportion of children diagnosed with severe pneumonia. Secondary outcomes included referred cases of severe pneumonia and treatment failure on day 14 after enrolment.Result Twenty-four health centres were randomised into intervention (928 children) and control arms (876 children). The proportion of children with severe pneumonia was 15.9% (148 of 928 children) in the intervention arm and 3.9% (34 of 876 children) in the control arm. After adjusting for differences in baseline variables children in the intervention arm were more likely to be diagnosed as severe pneumonia cases as compared with those in the control arm (adjusted OR: 5.4, 95% CI 2.0 to 14.3, p=0.001).Conclusion The combined use of IMCI and pulse oximetry in health centres increased the number of diagnosed severe childhood pneumonia.Trial registration number PACTR201807164196402.