0000005995 00000 n World Health Organization Pneumonia Vaccine Trial Investigators Group. In the interim, better ways to determine the aetiology of pneumonia need to be sought, and researchers should consider the benefits of using methods of classification to provide more homogeneous groups, the study of which is likely to provide clearer answers to research questions. Volume 5 of Pneumonia was a theme issue on the diagnosis of pneumonia. 47 0 obj <>stream #}zqQJ' Copyright World Health Organization 2014. Training PediCAP World Health Organization website; Available from. This site needs JavaScript to work properly. In a hyper-connected world,WHO-FIC with their shared terminologyare key for supporting natural language processing (NLP). Before As part of the merger of DIMDI with BfArM, contents of this website have been moved to the website www.bfarm.de. III. Support West and Central Africa network for operational research on barriers to introduction of digital health tools (ADP). Rasanen J, Gavriely N. Childhood pneumonia screener: a concept. Following the publication of a volume of Pneumonia focused on diagnosis, the journals Editorial Board members debated the definition and classification of pneumonia and came to a consensus on the need to revise both of these. 0000009213 00000 n Characterisation of children hospitalised with pneumonia in central Similarly, misclassification of pneumonia limits high quality epidemiological and clinical research. Pediatric Community-Acquired Pneumonia Treatment Guideline http://www.who.int/hrh/statistics/Health_workers_classification.pdf, TITLE: WHO Family of Classifications. 8600 Rockville Pike It is believed that they will be a good asset to demystify the misconceptions associated with reversal of eruption sequence in the community. The Federal Institute for Drugs and Medical Devices (Bundesinstitut fr Arzneimittel und Medizinprodukte, BfArM) is an independent higher federal authority within the portfolio of the Federal Ministry of Health (Bundesministerium fr Gesundheit, BMG). Digital health solutions are needed to prevent, detect and respond to epidemics and pandemics and to promote health and well-being with the aim to achieve the health-related Sustainable Development Goals (SDGs). ICD-10 Version. with no chest indrawing or general danger sign should be treated with oral amoxicillin: at least 40 mg/kg/dose twice daily (80mg/kg/day) for five days. A classic vaccine probe study was able to define the entity of viral-associated pneumococcal pneumonia providing a substantial advance in our understanding of pneumonia pathogenesis and aetiology [18]. One suggestion towards a definition of pneumonia was to take a descriptive approach: explaining anatomy and the respiratory ecosystem; describing what is meant by pneumonia; listing the causative organisms within the relevant context, and then proceeding to clinical definition(s). Lancet. Implementation research training materials. I.World Health Organization. Our Matomo installation works without tracking cookies. 919 0 obj <> endobj Cochrane Database Syst Rev. There was a correlation between negative beliefs about this variation and age (p = 0.038) and education (p = 0.020). The focus here is to illustrate the value of studying homogenous groups when the current lack of clarity in the classification of pneumonia results in a tendency towards the inclusion of heterogenous groups. Augmentin (amoxicillin/clavulanate) in the treatment of community-acquired respiratory tract infection: a review of the continuing development of an innovative antimicrobial agent. During the next 47years at least 28 terms were used to identify pneumonia [8], and by 1929 the total number of terms listed in the Manual of the International List of Causes of Death had grown to 94, with 12 sub-terms [9]. A more recent study by McNally and colleagues [12] extensively investigated children with severe or very severe pneumonia with half having failed therapy (a homogenous subgroup), and found that 18% had more than one aetiologic bacterial organism, thus establishing the paradigm of co-infection in pneumonia. The site is secure. Harrisons textbook of internal medicine defines pneumonia as an infection of the pulmonary parenchyma caused by various organisms. It needs to be considered how these two domainspublic health policy for the treatment and prevention of pneumonia, and research to answer specific questions of pathogenesis, diagnosis, treatment and preventioncan better interact. Handbook : IMCI integrated management of childhood illness. Aim: To assess the opinions of TBAs towards reversal of eruption sequence of primary central incisors in infants. <<9067BC1C47A40645BB93298593E4CF72>]/Prev 236484>> This recommendation was based on trial data from limited contexts whose generalisability is unclear. 0000044794 00000 n Although randomized controlled trials can provide information on the effectiveness of digital health tools, such trials do not assess the reach of e-health in vulnerable groups or assess whether digital health solutions can be scaled up outside of a study environment. HHS Vulnerability Disclosure, Help The site is secure. In studies of heterogeneous groups the research problems that may arise include an inability to determine aetiology due to a limited range of methods; pathology or microbiology with disparate patterns; and conflicting results between studies that investigate risk factors, diagnostic methods or treatments. It should be accepted that defining pneumonia as a group of specific (co)infections with different characteristics is an ideal, but this ideal currently has limited use because the identification of aetiologic organisms in individuals is often not possible. 0000043701 00000 n The agenda should also address the need to stimulate the development and testing of technologies, methods and infrastructures that overcome. 0000033067 00000 n You will find more detailed information and the possibilities to object to the use of Matomo in our data privacy declaration. Classifications of pneumonia in clinical care and research will be limited by the means available but can be made more specific using the approaches described in Table1, and combinations thereof (Table1 is not a complete list of all available approaches). 0 [Practical use of a personal computer at the work site]. When autocomplete results are available use up and down arrows to review and enter to select. The lack of clear classification results in difficulty with clinical decision making and a potential for poorly formulated research. JAMA 1889;:332. Management of Severe Childhood Pneumonia in Low-Resource - Springer In order to optimize the website, we use the analysis tool Matomo. Epub 2014 Mar 19. PDF Revised WHO classification and treatment of childhood pneumonia at 0000004378 00000 n Digital health technologies have different functions and can be used as solutions in the following five areas: When heterogeneous groups are studied, invalid estimates of effect occur due to misclassification bias [14]. Olubunmi Olusola Bankole, Juliana Obontu Taiwo, Adeyemi Isaiah Falegan, KEYWORDS: World Health Organization , Revised WHO Classification and Treatment of Childhood Pneumonia at Health Facilities: Implications for Policy and Implementation, WHO Department of Maternal, Child, Newborn and Adolescent Health, Geneva (2014). There was a correlation between negative beliefs about this variation and age (p = 0.038) and education (p = 0.020). Classifying leprosy patients--searching for the perfect solution? It was argued that the popular use of the term, community-acquired pneumonia does little to advance our understanding of the condition. The study of more homogenous phenotypes is likely to provide better evidence for clinical care and more clear inference in research. It aims to provide life-saving treatment based on the WHO protocols as well as few renewables & equipment needed for 100 cases, amongst which: 60 cases of children 5 years old and Created by: Kathy Berry. 8600 Rockville Pike Effect of enhanced feedback to hospitals that are part of an emerging Clipboard, Search History, and several other advanced features are temporarily unavailable. In a qualitative sense, the problem may be distilled to a lack of homogeneity in clinical and pathological phenotypes under investigation. In the current setting of limited diagnostic methods, this commentary proposes three points to ameliorate the difficulties with the definition and classification of pneumonia. Language: english. [WHO basic classification in forensic medicine] - PubMed The problem with our current approach to the classification of pneumonia is twofold: (i) it results in widespread empirical, and often unnecessary, use of antimicrobials that contributes to pathogen resistance; and (ii) it contributes to heterogeneity among the groups of subjects compared in research, causing misclassification bias and mixtures . 939 0 obj <>stream The role of rapid diagnostic tests in managing adults with pneumonia in low-resource settings. and the evidence supporting them, and to assist national child health programmes in revising their 0000001378 00000 n When autocomplete results are available use up and down arrows to review and enter to select. The magnitude of the problem is less evident in the field of pneumonia research. The https:// ensures that you are connecting to the 0000005834 00000 n Opinions of traditional birth attendants in Ibadan, Nigeria, towards reversal of eruption sequence of primary central incisors in infants. 0000008609 00000 n Accessibility 0000004649 00000 n Before Aston SJ. The site is secure. %%EOF Q. WHO classification: Surgical pathology A classification of non-Hodgkins lymphomas based upon an updated version of the REAL classification system; the WHO classification system is currently accepted as the authoritative standard for diagnosing lymphomas; it does not group lymphomas into prognostic categories, but, rather, considers each . Executive Summary - Revised WHO Classification and Treatment of Benefits of WHO-FIC. 2014 Jul;69(7):1954-9. doi: 10.1093/jac/dku070. Due to the current high workload enquiries concerning medical coding with OPS and ICD-10-GM cannot be answered for the time being, this does not include enquiries for COVID-19. Eruption Sequence; Infants; Opinions; Primary Central Incisors; Traditional Birth, JOURNAL NAME: Inclusion in an NLM database does not imply endorsement of, or agreement with, government site. MeSH National Library of Medicine Heterogeneous groups may result in disparate and unfocused studies, which fail to target the most important types of pneumonia and the most important questions, and make limited contributions. The revised guidelines present two major changes to existing guidelines: (A) there are now just 2 categories of pneumonia instead of 3 (pneumonia which is treated at home with oral amoxicillin and severe pneumonia which requires injectable antibiotics) and (B) oral amoxicillin replaces oral cotrimoxazole as first line treatment, preferably in 250mg dispersible tablet form, twice daily for five days which can be reduced to three days in low HIV settings. WHO pneumonia guidelines recommend that children (aged 2-59 months) with chest indrawing pneumonia and without any "general danger sign" can be treated with oral amoxicillin without hospital admission. As a library, NLM provides access to scientific literature. In: Rothman KJ, Greenland S, Lash TL, editors. The aim of this commentary is to stimulate debate towards consensus classifications for clinical terminology, separating bronchiolitis from pneumonia, examining the value of the community- and hospital-acquired classification, and purposeful refinement of classifications based on microbiology, aetiology, radiology, severity, complications, important age groups and subgroups. Haider BA, et al. However, taken to an extreme, the pursuit of representativeness can defeat the goal of identifying causal biological relations. WHO classification | definition of WHO - Medical Dictionary 0000011126 00000 n Bookshelf ICD-11, ICF and ICHI are key for effective knowledge representation and data transfer.. WHO Family of International Classifications (WHO-FIC) allows all healthcare workers (and patients) to communicate using one (technical) language. Currently, with over hundred thousand entities and the ontological design of the foundation component, more than one million terms can be captured. Revised WHO classification and treatment of pneumonia in children at health facilities: implications for policy and implementation. Sadly, the methods outlined are tried, but not necessarily trusted techniques for improving the diagnosis and classification of pneumonia. Disclaimer. The definition and classification of pneumonia - PMC MEDBOX | Revised WHO classification and treatment of childhood Based on Indonesia Health Profile Report in 2020, pneumonia, besides diarrhea, is one of the causes of high infant (14.5%) and toddler (5.05%) mortality in Indonesia [ 2 ]. 0000007240 00000 n Support for the Evaluation of the Med Safety App for reporting of adverse drug reaction (Ghana, Uganda, Burkina Faso) -, Support for the Evaluation of a USSD-based system for reporting of adverse drug reaction (Malawi) -, Support for development of an interactive e-learning platform for vaccine safety monitoring in the context of COVID-19 vaccines (Morocco WHO Collaborating Center for Pharmacovigilance) -. countries, perhaps for convenience, retain cotrimoxazole as their first-line treatment for childhood pneumonia, even though evidence shows it contributes to growing antibiotic . 2001 Jul;68 Suppl 3:S19-23. Revised WHO classification and treatment of pneumonia in children at health facilities: evidence summaries. Content based information retrieval in forensic image databases. Revised WHO Classification and Treatment of Pneumonia in Children at Health Facilities: Evidence Summaries. The lack of accepted, widely understood and commonly used definition(s) for pneumonia causes a fundamental problem where related but heterogeneous pathologies and clinical phenotypes are poorly classified. Lancet. For example, when comparing antibacterial therapies in patients with pneumonia, the internal validity of the study will be improved if the patient group is restricted to those with a proven bacterial cause; antibacterial therapy cannot benefit patients with viral pneumonia. Nihon Hoigaku Zasshi. Implementation research on digital health solutions is necessary to generate evidence on challenges using digital health technology in a given context such as (see table at right). guidelines to conform to the new recommendations. The medical literature includes the term pneumonia or pneumonitis in a collection of diagnostic terms for a number of conditions that are not related to infection or have an unknown cause, which illustrates the lack of consensus in the definition of pneumonia. Goals and uses]. ]&c**. The .gov means its official. If a specific diagnosis could be made, specific therapy could be provided which would be of similar efficacy to empiric wide spectrum therapy [13] and avoid millions of prescriptions of broad-spectrum antibiotics and the associated risks of antibiotic resistance. WHO-FIC with their shared terminologyare key for effective text mining or text analytics (the process of deriving high-quality information from plain and unstructured text). Careers. Revised WHO classification and treatment of pneumonia in children at Classifications. the International Statistical Classification of Diseases and Related Health Problems (ICD), WHO INN (non proprietary names - medicaments)/ATC. Amoxicillin Dispersible Tablets: Market and Supply - UNICEF 0000003439 00000 n A child dies of pneumonia every 43 seconds Pneumonia kills more children than any other infectious disease, claiming the lives of over 700,000 children under five every year, or around 2,000 every day. Pneumonia is a form of acute respiratory infection that is most commonly caused by viruses or bacteria. Ambulatory short-course high-dose oral amoxicillin for treatment of severe pneumonia in children: a randomised equivalency trial. This site needs JavaScript to work properly. official website and that any information you provide is encrypted hb`````Ic`e`? B@1V~``$tI+gVc%@`FGGXH7#E(f`zAK C b &^ l"> G @n0e(qY!AXgnY" g X* Overview Digital health solutions are needed to prevent, detect and respond to epidemics and pandemics and to promote health and well-being with the aim to achieve the health-related Sustainable Development Goals (SDGs). It may be that a greater focus on studying high-risk groups, specific aetiologies, very severe cases, patients with consolidation, narrow age groups, etc., may provide a greater yield of knowledge to support targeted interventions. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 930 0 obj <>/Filter/FlateDecode/ID[<64DF2ED1D4CD4769A956E1F739E15E3D><694A77AE363CAC4D91FE3A6CF4508C46>]/Index[919 21]/Info 918 0 R/Length 68/Prev 363422/Root 920 0 R/Size 940/Type/XRef/W[1 2 1]>>stream The diagnosis of pneumonia in the intensive care setting was noted as being particularly unreliable, although the evolving use of lung ultrasound offers more clarity. A child who is HIV positive %%EOF Careers. In the field of pneumonia research, determining aetiology is a common difficulty. In two consultations, experts updated recommendations for 1) preventing and managing pneumonia in HIV-infected and -exposed infants and children ( 9) and 2) for managing pneumonia in non-HIV-affected infants and children ( 5 ). Multi-country survey on malaria program challenges that could be improved by a digital solution, inventory of digital tools in use, and research needs faced by national malaria elimination programs. Statistically speaking, selection of participants who are representative of larger populations will often make it more difficult for internally valid inferences to be made, due to misclassification/heterogeneity of cases and an inability to control for confounding by factors that vary within those populations. World Health Organization - All rights reserved. and transmitted securely. 2.Child. The difficulty clinicians encounter in confidently identifying the causative agents of suspected pneumonia cases can lead to over-prescribing of broad-spectrum antimicrobial agents, which contributes to increasing health costs, risks adverse effects and promotes further antimicrobial resistance. 0000003552 00000 n Google Scholar The .gov means its official. Pneumonia: Age 259 months with cough or difficult breathing and fast breathing and/or chest in-drawing. The problem with our current approach to the classification of pneumonia is twofold: (i) it results in widespread empirical, and often unnecessary, use of antimicrobials that contributes to pathogen resistance; and (ii) it contributes to heterogeneity among the groups of subjects compared in research, causing misclassification bias and mixtures of effects that threaten internal validity. 0000021832 00000 n 2004 Jan;53 Suppl 1:i3-20. Bethesda, MD 20894, Web Policies
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