Outpatient Management of Children with World Health Organization Chest Indrawing Pneumonia: Implementation Risks and Proposed Solutions

Eric D. McCollum, Amy Sarah Ginsburg

Research output: Contribution to journalReview articlepeer-review

Abstract

This Viewpoints article details our recommendation for the World Health Organization Integrated Management of Childhood Illness guidelines to consider additional referral or daily monitoring criteria for children with chest indrawing pneumonia in low-resource settings. We review chest indrawing physiology in children and relate this to the risk of adverse pneumonia outcomes. We believe there is sufficient evidence to support referring or daily monitoring of children with chest indrawing pneumonia and signs of severe respiratory distress, oxygen saturation <93% (when not at high altitude), moderate malnutrition, or an unknown human immunodeficiency virus (HIV) status in an HIV-endemic setting. Pulse oximetry screening should be routine and performed at the earliest point in the patient care pathway as possible. If outpatient clinics lack capacity to conduct pulse oximetry, nutritional assessment, or HIV testing, then we recommend considering referral to complete the evaluation. When referral is not possible, careful daily monitoring should be performed.

Original languageEnglish (US)
Pages (from-to)1560-1564
Number of pages5
JournalClinical Infectious Diseases
Volume65
Issue number9
DOIs
StatePublished - Nov 1 2017

Keywords

  • World Health Organization Integrated Management of Child Illness guidelines
  • chest indrawing
  • child pneumonia
  • malnutrition
  • pulse oximetry

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Outpatient Management of Children with World Health Organization Chest Indrawing Pneumonia: Implementation Risks and Proposed Solutions'. Together they form a unique fingerprint.

Cite this