Outcome and management of children with chest indrawing pneumonia at primary health care settings in Pakistan: an observational cohort study

作者：Zamir Suhag, A. Pal, Muhammad Ahsan Naeem, Imran Ahmed, Noorulain Altaf Khuwaja, Shayan Khakwani, Ali Mujtaba, Shamim Qazi, Yasir Bin Nisar · 发表于：Journal of Global Health · 年份：2025 · DOI：10.7189/jogh.15.04096 · 被引用次数：5 · 研究领域：Pneumonia and Respiratory Infections、Antibiotic Use and Resistance、Nosocomial Infections in ICU

Background: Pneumonia is a major cause of childhood mortality in Pakistan. In 2019, the Government of Pakistan revised the national Integrated Management of Childhood Illness (IMCI) chart booklet, following the World Health Organization's recommendation for outpatient management with oral antibiotics of children aged 2-59 months with chest indrawing pneumonia. We aimed to assess the outcomes of children aged 2-59 months with chest indrawing pneumonia in programme setting of Pakistan. Methods: This was a prospective observational cohort study in three primary health care facilities in Thatta district, Sindh province. We screened children aged 2-59 months who presented with cough and/or difficult breathing, and recruited those classified with chest indrawing pneumonia according to the IMCI tool. from December 2022 to March 2024. The primary outcome was to assess the case fatality ratio. The secondary outcomes were to calculate the prevalence of antibiotic use, hospital admissions and treatment adherence among these children during the current illness. We followed up on day 15 after enrolment to assess outcomes. Results: 456 children with chest indrawing pneumonia met the study's enrolment criteria. Two (0.4%) died. Four (0.9%) were lost to follow-up and excluded from the analysis. According to parental/caregiver reports, among 452 children followed up on day 15, 435 (96.3%) were cured, 12 (2.7%) did not improve and two (0.4%) worsened and were hospitalised. All patients were tr...