Point-of-care diagnosis of severe acute respiratory tract infections in infants and young children \r
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The Bernhard Nocht Institute for Tropical Medicine (BNITM), Germany, and the St. Francis Xavier Hospital (SFXH) in Ghana’s Central Region are analysing the prognostic value of an adapted point-of-care testing (POCT) package including lung ultrasound for differential diagnosis of severe acute respiratory infections (SARI) in infants aged 60 days to 60 months. The aim of this is to improve clinical management, reduce the use of antibiotics and promote sensible prescribing practices. \r
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BNITM has run the Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), a research and training facility, with Ghanaian partners since 1997. SFXH is home to a laboratory and learning facility for KCCR.\r
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Background\r
Pneumonia kills more children worldwide than any other infectious disease. It is mainly caused by viruses. Nevertheless, it is difficult for medical staff to determine whether antimicrobial treatment is indicated. Doctors in hospitals and clinics need diagnostic methods for precise pathogen identification in order to manage antibiotic treatment. Diagnostic and clinical uncertainty often leads to unwarranted administration and escalated use of antibiotics.\r
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Activities\r
•\tExamination of the prognostic value of the POCT package compared to locally established PCR testing (BioFire) for differential diagnosis of SARI in infants and young children\r
•\tDevelopment of facility-specific guidelines for management of cases of severe respiratory tract infections in infants and young children and the targeted use of antibiotics\r
•\tTraining of hospital staff on scientific issues and treatment expertise\r
•\tEvaluation of activities in respect of sensible prescribing of antibiotics and investigation of potential resistance and other areas\r
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Impact\r
At least 300 children a year will be assessed as part of the study for differential diagnosis of SARI using the POCT package. For 10 per cent of the children admitted to SFXH with SARI, antibiotic treatment will be reduced by at least one antibiotic. The analysis will serve as a feasibility study and is intended to inform future clinical studies. The overall intention is to improve care for young patients with SARI.\r