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Childhood Pneumonia Diagnostics in Sub-Saharan Africa: A Systematic Review
Olutobi Babatope Ojuawo1, Pui-Ying Iroh Tam2,3,4
1Global Health Department, Liverpool School of Tropical Medicine, Liverpool, UK.
Insights
Diagnosing childhood pneumonia in sub-Saharan Africa is difficult. Microbiological tests are common, but more research is needed on serum biomarkers to differentiate bacterial and viral causes.
Area of Science:
- Pediatrics
- Infectious Diseases
- Diagnostic Medicine
Background:
- Accurate etiological diagnosis of childhood pneumonia is challenging in sub-Saharan Africa due to limited resources.
- Differentiating between bacterial and viral pneumonia is crucial for effective treatment.
Purpose of the Study:
- To review current diagnostic methods for childhood pneumonia in sub-Saharan Africa.
- To explore potential diagnostic modalities for distinguishing bacterial from viral pneumonia in the region.
Main Methods:
- A systematic literature search was conducted on online databases for studies published between January 2010 and December 2020.
- Studies focused on childhood pneumonia diagnosis in sub-Saharan Africa were selected and appraised using PRISMA and QUADAS-2 tools.
Main Results:
- Microbiological investigations were the most common diagnostic tests (79.7%), with blood samples frequently used (32.8%).
- Polymerase chain reaction (PCR) was the most utilized diagnostic modality (53.1%).
- Only six studies explored serum biomarkers, with combined biomarkers showing potential for differentiating etiologies.
Conclusions:
- Microbiological investigations are the primary diagnostic approach for childhood pneumonia in sub-Saharan Africa.
- Further research is essential to evaluate the efficacy of serum biomarkers, individually or in combination, for differentiating bacterial and viral pneumonia.
Background:
The prompt and accurate aetiological diagnosis of childhood pneumonia remains a challenge, especially in sub-Saharan Africa (SSA) because of limited resources for disease management.
Objective:
To review existing diagnostics for childhood pneumonia and potential modalities available to differentiate between bacterial and viral aetiologies in SSA.
Methods:
Online databases were searched for relevant articles published between January 2010 and December 2020 regarding childhood pneumonia diagnosis, conducted in SSA in children less than 18 years of age. The 2020 PRISMA checklist was utilized in appraising the selected studies and the QUADAS-2 tool was employed to assess the risk of bias in each of the studies selected.
Results:
A total of 1542 study titles and abstracts were screened following which 45 studies (39 on childhood pneumonia diagnostics and 6 on discriminating between bacterial and viral childhood pneumonia) were selected for review. Microbiological investigations (79.7%) constituted the most utilized index tests with blood-related specimen (32.8%) being the most utilized specimen. The most performed index diagnostic modality was polymerase chain reaction (PCR) (53.1%). The commonest reference gold standard technique was based on clinical diagnosis of the disease (46.2%). Only six studies in SSA attempted at using serum biomarkers, either singly or in combination to distinguish between aetiologies with use of combined biomarkers showing promise.
Conclusion:
Microbiological investigations are the most employed diagnostic methods for childhood pneumonia in SSA. More studies are required to evaluate the potential use of serum biomarkers; either singly or in combination with the goal of discriminating bacterial and viral childhood pneumonia.
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