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Institute for International Programs

Pneumonia Etiology Research for Child Health (PERCH)

The Care and Treatment of Severe Pneumonia in HIV-exposed and Infected Children (Zambia)

Pneumonia is the leading infectious cause of death in children. HIV-exposed and infected children are particularly susceptible to pneumonia but little information exists on the likelihood of and risk factors for mortality among hospitalized children with pneumonia. To address the gaps in knowledge, this study, nested within the Pneumonia Etiology Research for Child Health (PERCH) project, is evaluating treatment outcomes for severe and very severe pneumonia among hospitalized children enrolled at the site in Lusaka, Zambia.

The PERCH project is a multi-center, case-control study conducted in seven countries to determine the etiology of severe and very severe pneumonia among hospitalized children younger than five years of age. The PERCH Zambia site is led by investigators at Boston University and University of Zambia Teaching Hospital (UTH). Preliminary data from the PERCH site in Zambia indicated that there was little standardization of care of pneumonia in hospitalized children. To standardize and improve the care and management of these children, this sub-study developed, implemented, and evaluated a clinical guidance tool based on the WHO recommendations, including best practices specific to HIV-infected and exposed children. The clinical guidance tool was well-accepted and easy to use. Despite improving and standardizing the care received, the clinical guidance tool did not significantly reduce mortality. The tool appeared to be more effective among HIV-exposed but uninfected children and children younger than 6 months of age. Simple tools like these are needed to ensure that children hospitalized with pneumonia receive the best possible care in accordance with recommended guidelines.