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Home-based treatment for children with severe pneumonia with oral antibiotics as effective and safe as hospital treatment with injectable antibiotics

A randomized clinical trial carried out in Pakistan, with support from Boston University School of Public Health and WHO and published in The Lancet, shows that home treatment for children (age 3 to 59 months) with severe pneumonia with oral antibiotics (high dose amoxicillin) is just as effective and safe as hospital treatment with injectable antibiotics (ampicillin), confirming earlier findings from three trials conducted in hospitalized children comparing oral Vs injectable antibiotics. These conclusions do not apply to very severe pneumonia and settings with high HIV prevalence. The implications of these findings are substantial, as they may improve access of children with severe pneumonia to effective treatment while reducing referral, admission, risk of needle-borne infections and treatment and other related costs also for the family. More information is provided here.

Planning for IMCI implementation at district level: a capacity building workshop, Suez, Egypt, 16-19 February 2008

A workshop to build capacity of national IMCI coordinators and district staff in planning for IMCI implementation at district level was conducted in Suez, Egypt, from 16 to 19 February 2008. Technically and financially supported by the WHO Regional Office for the Eastern Mediterranean (EMRO) and conducted in Arabic, the four-day workshop was an opportunity not only to introduce the newly developed WHO/EMRO “Regional Guide on Planning for IMCI implementation at District level” to national coordinators from six countries (Egypt, Jordan, Morocco, Sudan, Tunisia and Yemen), but also to use it at the same time with 49 staff of six districts and with the participation of high-level officials of their respective governorates in Egypt. The outcome of the workshop was one-year plans of action for IMCI implementation developed for each district, including human resource development, health system support elements and community component.

Findings of the WHO EMRO Pediatric Hydrocarbon Study Group’s study on hydrocarbon (kerosene) poisoning in children published

The results of the WHO EMRO Pediatric Hydrocarbon Study Group’s study “A clinical decision rule for triage of children under 5 years of age with hydrocarbon (kerosene) aspiration in developing countries”, supported by this Regional Office, have been published in Clinical Toxicology, Volume 46, Issue 3 March 2008, pages 222 – 229. The study aimed to develop a clinical decision instrument to identify at primary health care facilities in developing countries children under-five exposed to hydrocarbon (kerosene) requiring referral to higher level facilities. The decision aid for referral decision is based on the presence of any of three clinical signs—which health providers trained in IMCI are able to assess—and requires no X-ray or laboratory facilities. It has a high sensitivity of 98% and specificity of 42%. The abstract of the paper can be accessed on the journal’s website. As the decision aid has initially been derived from cases seen only in one poison control centre in one country, it can not be extrapolated to, and needs to be validated in, other settings before it can be recommended for use. This information is provided for scientists of research institutions interested in validating the rule in their settings under strict research conditions. Protocols and instruments used in the study are available from the Child and Adolescent Health and Development (CAH) unit of this Regional Office.

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