Project Lead(s): Michael Hawkes
Issue
Globally, 2.1 million children die of pneumonia every year.
Most deaths occur in resource-poor settings, with countries in Africa and Asia reporting 2 to 10 times more children with pneumonia than industrialized countries.
A chest x-ray (CXR) is an essential diagnostic tool in the management of suspected pneumonia, but is not available in many healthcare facilities in Africa and Asia.
Solution
The idea of the project was to replace chest x-rays with a bedside, finger-prick blood test based on a clinically informative circulating protein biomarker of pneumonia.
This biomarker discovery project employed a cross-sectional design with prospective enrolment of children presenting with suspected pneumonia to one of two sites in Uganda, who underwent chest radiography and had peripheral venous blood samples drawn.
An expert radiologist in Edmonton, Alberta, reviewed all the chest x-rays and made a diagnosis of airspace consolidation (likely bacterial pneumonia, likely requiring antibiotic therapy), where appropriate.
The patient plasma, collected in Uganda, was shipped to Canada for analysis.
Commercial ELISA kits for putative biomarkers of pneumonia (including angiopoietin Ang-1, Ang-2, syndecan-4, uteroglobin, YKL-40, lipocalin 2, s-TREM-1, surfactant protein-D) have been purchased and the team is currently in the process of running these assays.
A total of 153 patients with clinically suspected pneumonia were enrolled between June 2014 and July 2015, and all were treated according to Ugandan national guidelines.
Outcome
Results of this project were not available because data analysis was ongoing.
The study was useful in building local clinical and diagnostic capacity in Uganda.
By obtaining chest x-rays for all participants, awareness of radiographic changes and their diagnostic significance was increased.
As children in this study were well treated according to guidelines, the mortality rate of 12% was below the expected mortality for children with severe pneumonia in a resource-limited setting.
If a promising biomarker is detected, the team will be applying for Phase II Transition To Scale funding.