Pulse oximetry for childhood pneumonia in rural Bangladesh

描述(由申请者提供)：这是Fogarty国际中心K01国际研究科学家发展奖的申请书，获奖者是约翰霍普金斯大学儿科呼吸科学部的儿科肺科专家Eric D.McCollum博士。麦科勒姆博士是资源匮乏国家儿童呼吸道疾病领域的初级临床研究员。这一K01奖项将为麦科勒姆博士提供实现以下目标所需的支持：(1)在亚洲资源有限的情况下成为临床研究实施和管理方面的专家；(2)发展先进研究设计和生物统计学方法方面的技能；以及(3)与儿科肺科医生开展多学科、远程合作。为了实现这些目标，McCollum博士精心组建了一个导师团队，成员包括：美国首席导师、约翰霍普金斯大学彭博公共卫生学院国际卫生系教授Abdullah Baqui博士、孟加拉国初级导师、约翰霍普金斯大学彭博公共卫生学院国际卫生系助理科学家、孟加拉国儿童健康专家Dipak Mitra博士和四位共同导师；儿童呼吸道流行病学与分析专家Katherine O‘Brien和Bareng Aletta Sanny Nonyane博士；以及肺病学专家Pamela Zeitlin和William Checkley博士。肺炎是全球和亚洲儿童死亡的头号原因。麦科勒姆博士的研究将利用正在进行的多中心肺炎球菌疫苗影响研究，评估脉搏血氧仪在孟加拉国农村儿童社区护理中作为肺炎诊断的作用(目标1)，并开发和验证适合亚洲社区护理的儿童呼吸系统疾病严重程度评分(目标2)。在目标1中，麦科勒姆博士将带领一个非专业社区卫生工作者(CHWS)团队招募1500名患有咳嗽和/或呼吸困难的孟加拉农村儿童，以评估低氧饱和度是否与放射肺炎有关。在目标2中，麦科勒姆博士将指导一个社区卫生组织团队招募2200名患有世界卫生组织定义的非严重肺炎的孟加拉农村儿童，以开发和验证可预测口服抗生素失效的风险评分，该风险评分适用于社区卫生组织。本申请中描述的研究将作为对干预试验的独立资助建议的基础，在亚洲农村社区护理项目中使用脉搏血氧仪作为诊断肺炎的工具，并作为评估肺炎严重程度的有效工具。

DESCRIPTION (provided by applicant): This is a submission for a Fogarty International Center K01 International Research Scientist Development Award for Dr. Eric D. McCollum, a pediatric pulmonologist at the Johns Hopkins Eudowood Division of Pediatric Respiratory Sciences. Dr. McCollum is a junior clinical investigator in the field of childhood respiratory illnesses in low-resource countries. This K01 award will provide Dr. McCollum with the support needed to achieve the following objectives: (1) to become an expert in clinical research implementation and management in Asian resource-limited settings; (2) to develop skills in advanced study design and biostatistical methods; and (3) formulate multidisciplinary, long-distance collaborations with pediatric pulmonologists. To accomplish these objectives, Dr. McCollum has crafted a mentoring team including a US primary mentor, Dr. Abdullah Baqui, Professor in the International Health Department of Johns Hopkins Bloomberg School of Public Health, an international leader of child health in low-resource Asian countries, and a Bangladesh primary mentor, Dr. Dipak Mitra, Assistant Scientist in the International Health Department of Johns Hopkins Bloomberg School of Public Health and a child health expert based in Bangladesh, as well as four co-mentors; Drs. Katherine O'Brien and Bareng Aletta Sanny Nonyane, experts in child respiratory epidemiology and analysis, respectively; and Drs. Pamela Zeitlin and William Checkley, both specialists in pulmonology. Pneumonia is the number one cause of childhood death globally as well as in Asia. Dr. McCollum's research will leverage the ongoing multicenter Pneumococcal Vaccine Impact study to evaluate pulse oximetry as a pneumonia diagnostic in the community care of rural Bangladeshi children (Aim 1) and to develop and validate a childhood respiratory illness severity score appropriate for community care in Asia (Aim 2). In Aim 1, Dr. McCollum will lead a team of lay community health workers (CHWs) in the enrollment of 1,500 rural Bangladeshi children sick with cough and/or difficulty breathing in order to assess whether a low oxygen saturation is associated with radiographic pneumonia. In Aim 2, Dr. McCollum will direct a team of CHWs to recruit 2,200 rural Bangladeshi children with World Health Organization-defined non-severe pneumonia in order to develop and validate a risk score predictive of oral antibiotic failure and appropriate for CHWs. The research described in this application will serve as the foundation for independent funding proposals for intervention trials using pulse oximetry in rural Asian community care programs as a diagnostic pneumonia tool and as a validated instrument to assess pneumonia severity.