Status: Funded - Open
The role and consequences of anemia in children with pneumonia
Peter Moschovis, M.D., MPH
BACKGROUND: Pneumonia is responsible for 1.2 million childhood deaths annually, mostly in low and middle-income countries; anemia affects half of children worldwide, and two thirds of children in sub-Saharan Africa and Southeast Asia. Since children with pneumonia ultimately die of insufficient delivery of oxygen to the tissues, the combination of reduced oxygen-carrying capacity from anemia and impaired oxygen uptake from pneumonia may be particularly harmful.
GAP: Prior to conducting a randomized clinical trial to evaluate whether blood transfusions reduce tissue hypoxia and improve outcomes in anemic children with pneumonia, it is necessary to first understand the natural history of pneumonia in patients with moderate/severe anemia, and the relationship between tissue hypoxia and outcomes.
HYPOTHESIS: Among children age 6 months to 5 years admitted to Mbarara Regional Referral Hospital in Southwest Uganda with WHO-defined severe pneumonia, we hypothesize that (1) children with lower hemoglobin will have longer time to resolution of hypoxemia and tachypnea, and (2) children with lower hemoglobin will have a higher blood lactate level.
METHODS: This will be a prospective cohort study of (1) the effect of low hemoglobin on time to resolution of pneumonia and (2) the effect of low hemoglobin on blood lactate, a marker of tissue hypoxia. We will measure hemoglobin and blood lactate on children age 6 months to 5 years admitted to Mbarara Regional Referral Hospital with WHO-defined severe pneumonia, following them until death, discharge, or resolution of pneumonia.
IMPACT: Given the burden of illness caused by pneumonia and anemia worldwide, further study on the overlap between these two diseases has the potential to impact the treatment of millions of children. This observational study will provide the background for a trial of transfusion strategies in children with anemia and pneumonia.
Massachusetts General Hospital
United States, Uganda