Article Text

other Versions

Download PDFPDF
Day-care management of severe and very severe pneumonia without any associated co-morbidities like severe malnutrition in an urban health clinic in Dhaka, Bangladesh
  1. Hasan Ashraf (ashrafh{at}
  1. ICDDR,B, Bangladesh
    1. Selina A Jahan (ashrafh{at}
    1. ICDDR,B, Bangladesh
      1. Nur H Alam (nhalam{at}
      1. ICDDR,B, Bangladesh
        1. Rokhsana Mahmud (ashrafh{at}
        1. ICDDR,B, Bangladesh
          1. S M Kamal (raddamch{at}
          1. Radda MCH-FP Centre, Dhaka, Bangladesh, Bangladesh
            1. Mohammed A Salam (masalam{at}
            1. ICDDR,B, Bangladesh
              1. Niklaus Gyr (niklaus.gyr{at}
              1. University of Basel, Switzerland


                Objective: Management of severe and very severe pneumonia in children relies on hospital-based treatment but practical barriers prevent these children in areas with highest rates from receiving hospital care. We developed and prospectively evaluated a day-care clinic approach that provided antibiotics, feeding and supportive care during day with continued care provided by parents at home as an effective alternative to hospitalization.

                Methods: Children aged 2-59 months with severe and very severe pneumonia without any associated co-morbidities, denied admission to hospital because of lack of beds were enrolled at Radda Clinic, Dhaka and received antibiotics, feeding and supportive cares from 8:00 am-5:00 pm every day, while mothers were educated on continuation of care at home during night hours.

                Results: From June 2003-May 2005, 251 children were enrolled. Severe and very severe pneumonia was present in 189/251 (75%) and 62/251 (25%) children, respectively while 143/251 (57%) were hypoxemic with mean (SD) oxygen saturation of 93 (4)% that increased to 98 (3)% upon oxygen therapy. The mean (SD) duration of day-care period was 7 (2) days. Successful management was possible in 234/251 [93% (95% CI, 89-96%)] children, 4.4% (95% CI, 2.5-7.7%) referred to hospitals, and 2.4% (95% CI, 1.1-5.1%) discontinued treatment. None died during day-care study period; however, during 3-months' follow-up period, 4/251 [1.6% (95% CI, 0.6-4%)] children died, and 11/251 [4.4% (95% CI, 2.5-7.7%)] required hospital admission.

                Conclusion: Severe and very severe pneumonia in children without any associated co-morbidities like severe malnutrition can be successfully managed at existing day-care clinics.

                • day-care management
                • severe pneumonia

                Statistics from

                Request Permissions

                If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

                Linked Articles

                • Atoms
                  Howard Bauchner