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  1. Article ; Online: Generalizability of Coronavirus Disease 2019 (COVID-19) Clinical Prediction Models.

    Hooli, Shubhada / King, Carina

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2020  Volume 71, Issue 15, Page(s) 897

    MeSH term(s) Antibody Formation ; Betacoronavirus ; COVID-19 ; Coronavirus ; Coronavirus Infections/epidemiology ; Humans ; Pandemics ; Pneumonia, Viral/epidemiology ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-04-10
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciaa417
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  4. Article ; Online: Generalizability of Coronavirus Disease 2019 (COVID-19) Clinical Prediction Models

    Hooli, Shubhada / King, Carina

    Clinical Infectious Diseases

    2020  Volume 71, Issue 15, Page(s) 897–897

    Keywords Microbiology (medical) ; Infectious Diseases ; covid19
    Language English
    Publisher Oxford University Press (OUP)
    Publishing country uk
    Document type Article ; Online
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciaa417
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  5. Article ; Online: Implication of the 2014 World Health Organization Integrated Management of Childhood Illness Pneumonia Guidelines with and without pulse oximetry use in Malawi: A retrospective cohort study.

    Hooli, Shubhada / Makwenda, Charles / Lufesi, Norman / Colbourn, Tim / Mvalo, Tisungane / McCollum, Eric D / King, Carina

    Gates open research

    2023  Volume 7, Page(s) 71

    Abstract: Background: Under-5 pneumonia mortality remains high in low-income countries. In 2014 the World Health Organization (WHO) advised that children with chest indrawing pneumonia, but without danger signs or peripheral oxygen saturation (SpO : Methods: ... ...

    Abstract Background: Under-5 pneumonia mortality remains high in low-income countries. In 2014 the World Health Organization (WHO) advised that children with chest indrawing pneumonia, but without danger signs or peripheral oxygen saturation (SpO
    Methods: Secondary analysis of 13,413 under-5 pneumonia cases in Malawi. Pneumonia associated case fatality ratios (CFR) were calculated by disease severity under the assumptions of the 2005 and 2014 WHO Integrated Management of Childhood Illness (IMCI) guidelines, with and without pulse oximetry. We investigated if pulse oximetry readings were missing not at random (MNAR).
    Results: The CFR of patients classified as having non-severe pneumonia per the 2014 IMCI guidelines doubled under the assumption that pulse oximetry was not available (1.5% without pulse oximetry vs 0.7% with pulse oximetry, P<0.001). When 2014 IMCI guidelines were applied with pulse oximetry and a SpO
    Conclusions: In Malawi, implementation of the 2014 WHO IMCI pneumonia guidelines, without pulse oximetry, will miss high risk cases. Alternatively, implementation of pulse oximetry may result in a large reduction in hospitalization rates without significantly increasing non-severe pneumonia associated CFR if the inability to obtain a pulse oximetry reading is considered a WHO danger sign.
    Language English
    Publishing date 2023-11-08
    Publishing country United States
    Document type Journal Article
    ISSN 2572-4754
    ISSN (online) 2572-4754
    DOI 10.12688/gatesopenres.13963.2
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  6. Article ; Online: Implication of the 2014 World Health Organization Integrated Management of Childhood Illness Pneumonia Guidelines with and without pulse oximetry use in Malawi

    Tisungane Mvalo / Eric D. McCollum / Charles Makwenda / Norman Lufesi / Carina King / Tim Colbourn / Shubhada Hooli

    Gates Open Research, Vol

    A retrospective cohort study [version 2; peer review: 2 approved]

    2023  Volume 7

    Abstract: Background Under-5 pneumonia mortality remains high in low-income countries. In 2014 the World Health Organization (WHO) advised that children with chest indrawing pneumonia, but without danger signs or peripheral oxygen saturation (SpO2) < 90% be ... ...

    Abstract Background Under-5 pneumonia mortality remains high in low-income countries. In 2014 the World Health Organization (WHO) advised that children with chest indrawing pneumonia, but without danger signs or peripheral oxygen saturation (SpO2) < 90% be treated in the community, rather than hospitalized. In Malawi there is limited pulse oximetry availability. Methods Secondary analysis of 13,413 under-5 pneumonia cases in Malawi. Pneumonia associated case fatality ratios (CFR) were calculated by disease severity under the assumptions of the 2005 and 2014 WHO Integrated Management of Childhood Illness (IMCI) guidelines, with and without pulse oximetry. We investigated if pulse oximetry readings were missing not at random (MNAR). Results The CFR of patients classified as having non-severe pneumonia per the 2014 IMCI guidelines doubled under the assumption that pulse oximetry was not available (1.5% without pulse oximetry vs 0.7% with pulse oximetry, P<0.001). When 2014 IMCI guidelines were applied with pulse oximetry and a SpO2 < 90% as the threshold for referral and/or admission, the number of cases meeting hospitalization criteria decreased by 70.3%. Unrecorded pulse oximetry readings were MNAR with an adjusted odds for mortality of 4.9 (3.8, 6.3), similar to that of a SpO2 < 90%. Although fewer girls were hospitalized, female sex was an independent mortality risk factor. Conclusions In Malawi, implementation of the 2014 WHO IMCI pneumonia guidelines, without pulse oximetry, will miss high risk cases. Alternatively, implementation of pulse oximetry may result in a large reduction in hospitalization rates without significantly increasing non-severe pneumonia associated CFR if the inability to obtain a pulse oximetry reading is considered a WHO danger sign.
    Keywords infant ; child ; pneumonia ; child mortality ; oximetry ; Malawi ; eng ; Medicine ; R
    Subject code 360
    Language English
    Publishing date 2023-11-01T00:00:00Z
    Publisher F1000 Research Ltd
    Document type Article ; Online
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  7. Article ; Online: Risk and accuracy of outpatient-identified hypoxaemia for death among suspected child pneumonia cases in rural Bangladesh: a multifacility prospective cohort study.

    McCollum, Eric D / Ahmed, Salahuddin / Roy, Arunangshu D / Islam, Asmd Ashraful / Schuh, Holly B / King, Carina / Hooli, Shubhada / Quaiyum, Mohammad Abdul / Ginsburg, Amy Sarah / Checkley, William / Baqui, Abdullah H / Colbourn, Tim

    The Lancet. Respiratory medicine

    2023  Volume 11, Issue 9, Page(s) 769–781

    Abstract: Background: Hypoxaemic pneumonia mortality risk in low-income and middle-income countries is high in children who have been hospitalised, but unknown among outpatient children. We sought to establish the outpatient burden, mortality risk, and prognostic ...

    Abstract Background: Hypoxaemic pneumonia mortality risk in low-income and middle-income countries is high in children who have been hospitalised, but unknown among outpatient children. We sought to establish the outpatient burden, mortality risk, and prognostic accuracy of death from hypoxaemia in children with suspected pneumonia in Bangladesh.
    Methods: We conducted a prospective community-based cohort study encompassing three upazila (subdistrict) health complex catchment areas in Sylhet, Bangladesh. Children aged 3-35 months participating in a community surveillance programme and presenting to one of three upazila health complex Integrated Management of Childhood Illness (IMCI) outpatient clinics with an acute illness and signs of difficult breathing (defined as suspected pneumonia) were enrolled in the study; because lower respiratory tract infection mortality mainly occurs in children younger than 1 year, the primary study population comprised children aged 3-11 months. Study physicians recorded WHO IMCI pneumonia guideline clinical signs and peripheral arterial oxyhaemoglobin saturations (SpO
    Findings: Participants were recruited between Sept 1, 2015, to Aug 31, 2017. During the study period, a total of 7440 children aged 3-35 months with the first suspected pneumonia episode were enrolled, of whom 3848 (54·3%) with an attempted pulse oximeter measurement and 2-week outcome were included in our primary study population of children aged 3-11-months. Among children aged 3-11 months, an SpO
    Interpretation: These findings support pulse oximeter use during the outpatient care of young children with suspected pneumonia in Bangladesh as well as the re-evaluation of the WHO IMCI currently recommended threshold of an SpO
    Funding: Fogarty International Center of the National Institutes of Health (K01TW009988), The Bill & Melinda Gates Foundation (OPP1084286 and OPP1117483), and GlaxoSmithKline (90063241).
    MeSH term(s) United States ; Humans ; Child ; Child, Preschool ; Prospective Studies ; Outpatients ; Bangladesh/epidemiology ; Cohort Studies ; Pneumonia/complications ; Hypoxia/diagnosis ; Hypoxia/etiology ; Oxygen
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2023-04-07
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 2686754-0
    ISSN 2213-2619 ; 2213-2600
    ISSN (online) 2213-2619
    ISSN 2213-2600
    DOI 10.1016/S2213-2600(23)00098-X
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  8. Article: Clinical hypoxemia score for outpatient child pneumonia care lacking pulse oximetry in Africa and South Asia.

    Schuh, Holly B / Hooli, Shubhada / Ahmed, Salahuddin / King, Carina / Roy, Arunangshu D / Lufesi, Norman / Islam, Asmd Ashraful / Mvalo, Tisungane / Chowdhury, Nabidul H / Ginsburg, Amy Sarah / Colbourn, Tim / Checkley, William / Baqui, Abdullah H / McCollum, Eric D

    Frontiers in pediatrics

    2023  Volume 11, Page(s) 1233532

    Abstract: Background: Pulse oximeters are not routinely available in outpatient clinics in low- and middle-income countries. We derived clinical scores to identify hypoxemic child pneumonia.: Methods: This was a retrospective pooled analysis of two outpatient ... ...

    Abstract Background: Pulse oximeters are not routinely available in outpatient clinics in low- and middle-income countries. We derived clinical scores to identify hypoxemic child pneumonia.
    Methods: This was a retrospective pooled analysis of two outpatient datasets of 3-35 month olds with World Health Organization (WHO)-defined pneumonia in Bangladesh and Malawi. We constructed, internally validated, and compared fit & discrimination of four models predicting SpO
    Results: 12,712 observations were included. The independent and composite LASSO models discriminated moderately (both C-statistic 0.77) between children with a SpO
    Conclusions: In the absence of pulse oximeters, both LASSO models better identified outpatient hypoxemic pneumonia cases than the WHO guidelines. Score external validation and implementation are needed.
    Language English
    Publishing date 2023-10-04
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2023.1233532
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  9. Article ; Online: Defining hypoxaemia from pulse oximeter measurements of oxygen saturation in well children at low altitude in Bangladesh: an observational study.

    McCollum, Eric D / King, Carina / Ahmed, Salahuddin / Hanif, Abu A M / Roy, Arunangshu D / Islam, Asmd Ashraful / Colbourn, Tim / Schuh, Holly B / Ginsburg, Amy Sarah / Hooli, Shubhada / Chowdhury, Nabidul H / Rizvi, Syed J R / Begum, Nazma / Baqui, Abdullah H / Checkley, William

    BMJ open respiratory research

    2021  Volume 8, Issue 1

    Abstract: Background: WHO defines hypoxaemia, a low peripheral arterial oxyhaemoglobin saturation (SpO: Methods: We prospectively enrolled well, children aged 3-35 months participating in a pneumococcal vaccine evaluation in Sylhet district, Bangladesh between ...

    Abstract Background: WHO defines hypoxaemia, a low peripheral arterial oxyhaemoglobin saturation (SpO
    Methods: We prospectively enrolled well, children aged 3-35 months participating in a pneumococcal vaccine evaluation in Sylhet district, Bangladesh between June and August 2017. Trained health workers conducting community surveillance measured the SpO
    Results: Our primary analytical sample included 1470 children (mean age 18.6±9.5 months). Median SpO
    Conclusion: A SpO
    MeSH term(s) Adolescent ; Altitude ; Bangladesh/epidemiology ; Child ; Child, Preschool ; Humans ; Hypoxia/diagnosis ; Hypoxia/epidemiology ; Infant ; Oximetry ; Oxygen Saturation
    Language English
    Publishing date 2021-11-02
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2736454-9
    ISSN 2052-4439 ; 2052-4439
    ISSN (online) 2052-4439
    ISSN 2052-4439
    DOI 10.1136/bmjresp-2021-001023
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  10. Article ; Online: The Epidemiology of Hypoxemic Pneumonia among Young Infants in Malawi.

    Hooli, Shubhada / King, Carina / Zadutsa, Beatiwel / Nambiar, Bejoy / Makwenda, Charles / Masache, Gibson / Lufesi, Norman / Mwansambo, Charles / Malla, Lucas / Costello, Anthony / Colbourn, Tim / McCollum, Eric D

    The American journal of tropical medicine and hygiene

    2020  Volume 102, Issue 3, Page(s) 676–683

    Abstract: We describe hypoxemic pneumonia prevalence in outpatient and inpatient settings, in-hospital mortality, and clinical guideline performance for identifying hypoxemia in young infants in Malawi. In this retrospective analysis of a prospective cohort study, ...

    Abstract We describe hypoxemic pneumonia prevalence in outpatient and inpatient settings, in-hospital mortality, and clinical guideline performance for identifying hypoxemia in young infants in Malawi. In this retrospective analysis of a prospective cohort study, we investigate infants younger than 2 months participating in pneumonia surveillance at seven hospitals and 18 outpatient health centers in Malawi between 2011 and 2014. Logistic regression, multiple imputation with chained equations, and pattern mixture modeling were used to determine the association between peripheral capillary oxyhemoglobin saturation (SpO
    MeSH term(s) Female ; Humans ; Hypoxia ; Infant ; Infant, Newborn ; Malawi/epidemiology ; Male ; Oximetry ; Oxygen/blood ; Pneumonia, Bacterial/epidemiology ; Pneumonia, Bacterial/pathology ; Prevalence
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2020-01-23
    Publishing country United States
    Document type Journal Article ; Observational Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2942-7
    ISSN 1476-1645 ; 0002-9637
    ISSN (online) 1476-1645
    ISSN 0002-9637
    DOI 10.4269/ajtmh.19-0516
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