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Assembling a global database of child pneumonia studies to inform WHO pneumonia management algorithm: Methodology and applications

Martin, Helena, Falconer, Jennifer, Addo-Yobo, Emmanuel, Aneja, Satinder, Arroyo, Luis Martinez, Asghar, Rai, Awasthi, Shally, Banajeh, Salem, Bari, Abdul, Basnet, Sudha, Bavdekar, Ashish, Bhandari, Nita, Bhatnagar, Shinjini, Bhutta, Zulfiqar A, Brooks, Abdullah, Chadha, Mandeep, Chisaka, Noel, Chou, Monidarin, Clara, Alexey W, Colbourn, Tim, Cutland, Clare, D'Acremont, Valérie, Echavarria, Marcela, Gentile, Angela, Gessner, Brad, Gregory, Christopher J., Hazir, Tabish, Hibberd, Patricia L., Hirve, Siddhivinayak, Hooli, Shubhada, Iqbal, Imran, Jeena, Prakash, Kartasasmita, Cissy B, King, Carina, Libster, Romina, Lodha, Rakesh, Lozano, Juan M, Lucero, Marilla, Lufesi, Norman, MacLeod, William B, Madhi, Shabir Ahmed, Mathew, Joseph L, Maulen-Radovan, Irene, McCollum, Eric D, Mino, Greta, Mwansambo, Charles, Neuman, Mark I, Nguyen, Ngoc Tuong Vy, Nunes, Marta C, Nymadawa, Pagbajabyn, O'Grady, Kerry-Ann F, Pape, Jean-William, Paranhos-Baccala, Glaucia, Patel, Archana, Picot, Valentina Sanchez, Rakoto-Andrianarivelo, Mala, Rasmussen, Zeba, Rouzier, Vanessa, Russomando, Graciela, Ruvinsky, Raul O, Sadruddin, Salim, Saha, Samir K., Santosham, Mathuram, Singhi, Sunit, Soofi, Sajid, Strand, Tor A, Sylla, Mariam, Thamthitiwat, Somsak, Thea, Donald M, Turner, Claudia, Vanhems, Philippe, Wadhwa, Nitya, Wang, Jianwei, Akramuzzaman, SyedMohd, Campbell, Harry, Nair, Harish, Qazi, Shamim Ahmad and Nisar, Yasir Bin (2022) 'Assembling a global database of child pneumonia studies to inform WHO pneumonia management algorithm: Methodology and applications'. Journal of global health, Vol 12, e04075.

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The existing World Health Organization (WHO) pneumonia case management guidelines rely on clinical symptoms and signs for identifying, classifying, and treating pneumonia in children up to 5 years old. We aimed to collate an individual patient-level data set from large, high-quality pre-existing studies on pneumonia in children to identify a set of signs and symptoms with greater validity in the diagnosis, prognosis, and possible treatment of childhood pneumonia for the improvement of current pneumonia case management guidelines.

Using data from a published systematic review and expert knowledge, we identified studies meeting our eligibility criteria and invited investigators to share individual-level patient data. We collected data on demographic information, general medical history, and current illness episode, including history, clinical presentation, chest radiograph findings when available, treatment, and outcome. Data were gathered separately from hospital-based and community-based cases. We performed a narrative synthesis to describe the final data set.

Forty-one separate data sets were included in the Pneumonia Research Partnership to Assess WHO Recommendations (PREPARE) database, 26 of which were hospital-based and 15 were community-based. The PREPARE database includes 285 839 children with pneumonia (244 323 in the hospital and 41 516 in the community), with detailed descriptions of clinical presentation, clinical progression, and outcome. Of 9185 pneumonia-related deaths, 6836 (74%) occurred in children <1 year of age and 1317 (14%) in children aged 1-2 years. Of the 285 839 episodes, 280 998 occurred in children 0-59 months old, of which 129 584 (46%) were 2-11 months of age and 152 730 (54%) were males.

This data set could identify an improved specific, sensitive set of criteria for diagnosing clinical pneumonia and help identify sick children in need of referral to a higher level of care or a change of therapy. Field studies could be designed based on insights from PREPARE analyses to validate a potential revised pneumonia algorithm. The PREPARE methodology can also act as a model for disease database assembly.

Item Type: Article
Subjects: WA Public Health > Health Administration and Organization > WA 530 International health administration
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 202 Pneumonia (General or not elsewhere classified)
WS Pediatrics > Diseases of Children and Adolescents > General Diseases > WS 200 General works
Faculty: Department: Education
Digital Object Identifer (DOI):
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 31 Jan 2023 14:38
Last Modified: 31 Jan 2023 14:38


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