What HIFA2015 members say
Meeting information needs to diagnose and manage childhood pneumonia
Please find below extracts from messages sent on the HIFA2015 and CHILD2015 email forums. Further content will be added on an ongoing basis.
‘As a paediatrician in Papua New Guinea and other developing countries I have seen scores of children die from pneumonia, often because they were brought to hospital too late, or health workers did not recognize that they needed oxygen and antibiotics. Many of these children arrived at hospital gasping and blue, or died along the way. The parents did not recognise the infant was ill, they could not afford the bus fare to hospital, the clinic was closed, the hospital was out of oxygen, the parents forgot to bring their infant for vaccines, the mothers milk supply ran out, they were not aware of weaning foods - the reasons go on and on… there is an urgent need for coordinated global and local action.’
Trevor Duke, Australia (March 2009) [Originally published on Nicholas Kristoff's blog, New York Times]
1. Understanding information needs
“I worked in CMC Vellore as well at St Johns Hospital Bangalore and there often we used to come across children who had scald marks around the area of the diaphragm if a child had pneumonia [as diagnosed by traditional healers]“
Maryann V Charles, India (October 2008)
“How many caregivers realise the danger to small children from smoke from
indoor cooking?”
David Morley (September 2006)
2. Undertaking and publishing research on childhood pneumonia
“Abstracts can have important omissions. The abstract of a Lancet article says: ‘Home treatment with high-dose oral amoxicillin is equivalent to currently recommended hospitalisation and parenteral ampicillin for treatment of severe pneumonia without underlying complications’ (Hazir T et al. Ambulatory short-course high-dose oral amoxicillin for treatment of severe pneumonia in children: a randomised equivalency trial. Lancet 2008; 371:49-56). But it fails to mention an important caveat, which is only stated in the full text: ‘We are unable to comment on the usefulness of ambulatory treatment in an HIV-exposed paediatric population, although other investigators have shown that empiric treatment of severe pneumonia with oral amoxicillin alone is insufficient in areas of high HIV prevalence.’ A WHO Press Release about this study also failed to mention this caveat.”
Neil Pakenham-Walsh (January 2008)
3. Synthesizing knowledge
4. Making knowledge available
Contributors
Trevor Duke is the Director of the Centre for International Child Health at the University of Melbourne. The Centre is a WHO Collaborating Centre for Research and Training in Child and Neonatal Health. The Centre is extensively involved with WHO’s Child Survival Strategy, and Hospital Care Quality Improvement approach. Trevor works closely with countries throughout the Asia-Pacific Region, particularly Papua New Guinea and the Solomon Islands, on child health policy, research and health worker training.
David Morley (d. 2009) was President of Teaching-aids At Low Cost, a UK-based non-governmental organisation. He was also Professor Emeritus at the Institute of Child Health, London.
Maryann V Charles is a postgraduate nurse specialised in child health. She is presently working on a fellowship called the health and population innovation fellowship offered by the Population Council; consulting with International Training and Education and Center on HIV-India office; and Training coordinator for Catholic Health Association of India. She has always worked with children but for the past 3 years she has focused on capacity building of nurses with regards to HIV care and treatment. She has worked in academia for more than 10 years, and feels there is a need to develop materials focused on care givers of children.
Neil Pakenham-Walsh is the coordinator of the HIFA2015 campaign and co-director of the Global Healthcare Information Network. He started his career as a hospital doctor in the UK, and has clinical experience in rural Ecuador and Peru. For the last 18 years he has been committed to improving the availability of healthcare information for health workers in developing countries. He has worked with the World Health Organization, the Wellcome Trust, and INASP. neil.pakenham-walsh AT ghi-net.org
