Global PARITY: Study Design for a Multi-Centered, International Point Prevalence Study to Estimate the Burden of
Qalab Abbas1, Adrian Holloway2, Paula Caporal3,4
1Department of Pediatrics and Child Health, Aga Khan University Karachi, Karachi, Pakistan.
Insights
This study investigates pediatric critical illness in resource-limited settings (RLS), revealing crucial data on prevalence, causes, and resource use to improve child healthcare outcomes globally.
Area of Science:
- Global Health
- Pediatric Critical Care
- Epidemiology
Background:
- The burden of pediatric critical illness and resource utilization in resource-limited settings (RLS) remains largely unknown.
- Lack of specific data hinders the development of evidence-based interventions for pediatric critical care in RLS.
- This study aims to determine the prevalence, etiology, outcomes, and resource utilization of pediatric critical illness in RLS globally.
Purpose of the Study:
- To address the significant knowledge gap in pediatric critical illness within RLS.
- To provide data on the prevalence, causes, and hospital outcomes of critically ill children in RLS.
- To inform the allocation of limited resources and guide clinical management decisions.
Main Methods:
- A prospective, observational, multicenter, multinational point prevalence study across 61 hospitals in RLS.
- Enrolled children aged 29 days to 14 years presenting with acute illness or injury.
- Collected data on critical illness prevalence, etiology, resource utilization, and hospital outcomes over 12 months with four sampling points.
Main Results:
- The study is expected to quantify the prevalence and characteristics of pediatric critical illness in diverse RLS.
- It will identify common etiologies and patterns of resource utilization for critically ill children.
- Data on hospital outcomes, including mortality and length of stay, will be generated.
Conclusions:
- This research will fill a critical gap in understanding pediatric critical illness in RLS.
- The findings are essential for informing future research and improving clinical management.
- The study aims to enhance global pediatric hospital outcomes through evidence-based strategies.
Background:
The burden of pediatric critical illness and resource utilization by children with critical illness in resource limited settings (RLS) are largely unknown. Without specific data that captures key aspects of critical illness, disease presentation, and resource utilization for pediatric populations in RLS, development of a contextual framework for appropriate, evidence-based interventions to guide allocation of limited but available resources is challenging. We present this methods paper which describes our efforts to determine the prevalence, etiology, hospital outcomes, and resource utilization associated with pediatric acute, critical illness in RLS globally.
Methods:
We will conduct a prospective, observational, multicenter, multinational point prevalence study in sixty-one participating RLS hospitals from North, Central and South America, Africa, Middle East and South Asia with four sampling time points over a 12-month period. Children aged 29 days to 14 years evaluated for acute illness or injury in an emergency department) or directly admitted to an inpatient unit will be enrolled and followed for hospital outcomes and resource utilization for the first seven days of hospitalization. The primary outcome will be prevalence of acute critical illness, which Global PARITY has defined as death within 48 hours of presentation to the hospital, including ED mortality; or admission/transfer to an HDU or ICU; or transfer to another institution for a higher level-of-care; or receiving critical care-level interventions (vasopressor infusion, invasive mechanical ventilation, non-invasive mechanical ventilation) regardless of location in the hospital, among children presenting to the hospital. Secondary outcomes include etiology of critical illness, in-hospital mortality, cause of death, resource utilization, length of hospital stay, and change in neurocognitive status. Data will be managed via REDCap, aggregated, and analyzed across sites.
Discussion:
This study is expected to address the current gap in understanding of the burden, etiology, resource utilization and outcomes associated with pediatric acute and critical illness in RLS. These data are crucial to inform future research and clinical management decisions and to improve global pediatric hospital outcomes.
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