Feasibility of Training Clinical Officers in Point-of-Care Ultrasound for Pediatric Respiratory Diseases in Aweil, South Sudan.
MetadataShow full item record
AbstractLower respiratory tract infections (LRTIs) are the leading cause of deaths in children < 5 years old worldwide, particularly affecting low-resource settings such as Aweil, South Sudan. In these settings, diagnosis can be difficult because of either lack of access to radiography or clinical algorithms that overtreat children with antibiotics who only have viral LRTIs. Point-of-care ultrasound (POCUS) has been applied to LRTIs, but not by nonphysician clinicians, and with limited data from low-resource settings. Our goal was to examine the feasibility of training the mid-level provider cadre clinical officers (COs) in a Médecins Sans Frontières project in South Sudan to perform a POCUS algorithm to differentiate among causes of LRTI. Six COs underwent POCUS training, and each subsequently performed 60 lung POCUS studies on hospitalized pediatric patients < 5 years old with criteria for pneumonia. Two blinded experts, with a tiebreaker expert adjudicating discordant results, served as a reference standard to calculate test performance characteristics, assessed image quality and CO interpretation. The COs performed 360 studies. Reviewers rated 99.1% of the images acceptable and 86.0% CO interpretations appropriate. The inter-rater agreement (κ) between COs and experts for lung consolidation with air bronchograms was 0.73 (0.63-0.82) and for viral LRTI/bronchiolitis was 0.81 (0.74-0.87). It is feasible to train COs in South Sudan to use a POCUS algorithm to diagnose pneumonia and other pulmonary diseases in children < 5 years old.
- Agreement Between the World Health Organization Algorithm and Lung Consolidation Identified Using Point-of-Care Ultrasound for the Diagnosis of Childhood Pneumonia by General Practitioners.
- Authors: Chavez MA, Naithani N, Gilman RH, Tielsch JM, Khatry S, Ellington LE, Miranda JJ, Gurung G, Rodriguez S, Checkley W
- Issue date: 2015 Aug
- Oxygen therapy for lower respiratory tract infections in children between 3 months and 15 years of age.
- Authors: Rojas-Reyes MX, Granados Rugeles C, Charry-Anzola LP
- Issue date: 2014 Dec 10
- Lung ultrasound as a diagnostic tool for radiographically-confirmed pneumonia in low resource settings.
- Authors: Ellington LE, Gilman RH, Chavez MA, Pervaiz F, Marin-Concha J, Compen-Chang P, Riedel S, Rodriguez SJ, Gaydos C, Hardick J, Tielsch JM, Steinhoff M, Benson J, May EA, Figueroa-Quintanilla D, Checkley W, Lung Ultrasound for Pneumonia Assessment (LUPA) Study Investigators.
- Issue date: 2017 Jul
- Point-of-Care Ultrasound as Part of a Short-Term Medical Mission to Rural Nicaragua.
- Authors: Barron KR, Lai JC, MenkinSmith LP, Lee JS, Humphrey ME, Hall JW
- Issue date: 2018 Jul
- RSV frequency in children below 2 years hospitalized for lower respiratory tract infections.
- Authors: Hacımustafaoğlu M, Celebi S, Bozdemir SE, Ozgür T, Ozcan I, Güray A, Cakır D
- Issue date: 2013 Mar-Apr