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dc.contributor.authorHazir, T.
dc.contributor.authorBegum, Khadija
dc.contributor.authorel Arifeen, S.
dc.contributor.authorKhan, Amira M.
dc.contributor.authorHuque, M.H.
dc.contributor.authorKazmi, N.
dc.contributor.authorRoy, Sushmita
dc.contributor.authorAbbasi, Saleem
dc.contributor.authorRahman, Qazi Sadeq-ur
dc.contributor.authorTheodoratou, E.
dc.contributor.authorKhorshed, M.S.
dc.contributor.authorRahman, Kazi M.
dc.contributor.authorBari, S.
dc.contributor.authorKaiser, M.M.I.
dc.contributor.authorSaha, S.K.
dc.contributor.authorAhmed, A.S.M. Nawshad Uddin
dc.contributor.authorRudan, Igor
dc.contributor.authorBryce, J.
dc.contributor.authorQazi, S.A.
dc.contributor.authorCampbell, H.
dc.date.accessioned2018-01-19T04:42:02Z
dc.date.available2018-01-19T04:42:02Z
dc.date.issued2013
dc.identifier.issn1549-1277
dc.identifier.doi10.1371/journal.pmed.1001422
dc.identifier.urihttp://hdl.handle.net/10072/173733
dc.description.abstractBackground: Antibiotic treatment for pneumonia as measured by Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) is a key indicator for tracking progress in achieving Millennium Development Goal 4. Concerns about the validity of this indicator led us to perform an evaluation in urban and rural settings in Pakistan and Bangladesh. Methods and Findings: Caregivers of 950 children under 5 y with pneumonia and 980 with ‘‘no pneumonia’’ were identified in urban and rural settings and allocated for DHS/MICS questions 2 or 4 wk later. Study physicians assigned a diagnosis of pneumonia as reference standard; the predictive ability of DHS/MICS questions and additional measurement tools to identify pneumonia versus non-pneumonia cases was evaluated. Results at both sites showed suboptimal discriminative power, with no difference between 2- or 4-wk recall. Individual patterns of sensitivity and specificity varied substantially across study sites (sensitivity 66.9% and 45.5%, and specificity 68.8% and 69.5%, for DHS in Pakistan and Bangladesh, respectively). Prescribed antibiotics for pneumonia were correctly recalled by about two-thirds of caregivers using DHS questions, increasing to 72% and 82% in Pakistan and Bangladesh, respectively, using a drug chart and detailed enquiry. Conclusions: Monitoring antibiotic treatment of pneumonia is essential for national and global programs. Current (DHS/ MICS questions) and proposed new (video and pneumonia score) methods of identifying pneumonia based on maternal recall discriminate poorly between pneumonia and children with cough. Furthermore, these methods have a low yield to identify children who have true pneumonia. Reported antibiotic treatment rates among these children are therefore not a valid proxy indicator of pneumonia treatment rates. These results have important implications for program monitoring and suggest that data in its current format from DHS/MICS surveys should
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherPublic Library of Sciences
dc.relation.ispartofpagefrome1001422-1
dc.relation.ispartofpagetoe1001422-12
dc.relation.ispartofissue5
dc.relation.ispartofjournalPlos Medicine
dc.relation.ispartofvolume10
dc.subject.fieldofresearchClinical Sciences not elsewhere classified
dc.subject.fieldofresearchMedical and Health Sciences
dc.subject.fieldofresearchcode110399
dc.subject.fieldofresearchcode11
dc.titleMeasuring Coverage in MNCH: A Prospective Validation Study in Pakistan and Bangladesh on Measuring Correct Treatment of Childhood Pneumonia
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
dcterms.licensehttps://creativecommons.org/licenses/by/4.0/
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© 2013 Hazir et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
gro.hasfulltextFull Text
gro.griffith.authorRahman, Kazi M.


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