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    Jan 17, 2021
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    Feasibility of Training Clinical Officers in Point-of-Care Ultrasound for Pediatric Respiratory Diseases in Aweil, South Sudan.

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    Nadimpalli et al 2019 Feasibility ...
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    Authors
    Nadimpalli, A
    Tsung, JW
    Sanchez, R
    Shah, S
    Zelikova, E
    Umphrey, L
    Hurtado, N
    Gonzalez, A
    Teicher, C
    Issue Date
    2019-09-01
    Submitted date
    2019-10-16
    
    Metadata
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    Journal
    American Journal of Tropical Medicine & Hygiene
    Abstract
    Lower 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.
    Publisher
    American Society of Tropical Medicine and Hygiene
    URI
    http://hdl.handle.net/10144/619478
    DOI
    10.4269/ajtmh.18-0745
    PubMed ID
    31287049
    Language
    en
    ISSN
    1476-1645
    ae974a485f413a2113503eed53cd6c53
    10.4269/ajtmh.18-0745
    Scopus Count
    Collections
    Paediatrics

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