Ghana Clinical Trial for Respiratory Distress in Children

Decreasing Acute Respiratory Morbidity at the District Hospital Level

Acute respiratory infections, malaria, and sepsis remain leading causes of death in children worldwide. Undifferentiated respiratory distress and, specifically, pneumonia have represented a diagnostic and therapeutic challenge. In 2011, sidHARTe evaluated the feasibility of continuous positive airway pressure (CPAP), a form of non-invasive ventilation, in decreasing all-cause mortality in children presenting with undifferentiated respiratory distress.  This study, a randomized clinical trial evaluating nasal continuous positive airway pressure (CPAP) for acute respiratory distress, was performed in four rural districts (secondary care) hospitals in Bono East and Ashanti Regions of Ghana.  The study cohort was pediatric patients three months to five years in acute respiratory distress in these rural and periurban communities. Similar studies at the time demonstrated the effectiveness of CPAP by physicians at urban tertiary hospitals. sidHARTe was able to show CPAP was successfully applied by task shifting and sharing to nurses at the district hospital level with no complications associated with use in children with nonspecific respiratory distress.