title: Improving the Diagnosis, Management, and Outcomes of Children with Pneumonia: Where are the Gaps?
abstract: Pneumonia is the greatest contributor to childhood mortality and morbidity in resource-poor regions, while in high-income countries it is one of the most common reasons for clinic attendance and hospitalization in this age group. Furthermore, pneumonia in children increases the risk of developing chronic pulmonary disorders in later adult life. While substantial advances in managing childhood pneumonia have been made, many issues remain, some of which are highlighted in this perspective. Multiple studies are required as many factors that influence outcomes, such as etiology, patient characteristics, and prevention strategies can vary between and within countries and regions. Also, outside of vaccine studies, most randomized controlled trials (RCTs) on pneumonia have been based in resource-poor countries where the primary aim is usually prevention of mortality. Few RCTs have focused on medium to long-term outcomes or prevention. We propose different tiers of primary outcomes, where in resource-rich countries medium to long-term sequelae should also be included and not just the length of hospitalization and readmission rates.
authors.affiliation: Queensland Children's Respiratory Centre, Queensland Children's Medical Research Institute, Queensland University of Technology , Brisbane, QLD , Australia ; Child Health Division, Menzies School of Health Research, Charles Darwin University , Darwin, NT , Australia.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Chang
authors.affiliation: Department of Pediatrics, Kuching Hospital , Sarawak , Malaysia.
authors.forename: Mong H
authors.initials: MH
authors.lastname: Ooi
authors.affiliation: Institute of Health and Community Medicine, Universiti Malaysia Sarawak , Kota Samarahan , Malaysia.
authors.forename: David
authors.initials: D
authors.lastname: Perera
authors.affiliation: Queensland Children's Medical Research Institute, The University of Queensland , Brisbane, QLD , Australia ; Queensland Paediatric Infectious Diseases Laboratory, Royal Children's Hospital , Brisbane, QLD , Australia.
authors.forename: Keith
authors.initials: K
authors.lastname: Grimwood
keywords: acute respiratory infections; diagnosis; outcomes; pneumonia; treatment