As it stands right now, in order to properly diagnose pneumonia and understand its severity, you require a specialist doctor and rather costly equipment like an X-ray machine. Sadly, neither of these things is available to most aid workers in developing nations, where 99% of the annual 1.1 million childhood deaths related to pneumonia occur. Elina Naydenova wished to change that.
Hailing from Oxford University’s Institute for Biomedical Engineering, Naydenova explains, “With the nearest hospital hours away, generalist health workers depend on a set of guidelines known as IMCI. These can sometimes be good at identifying cases of pneumonia but not so good at screening out cases that are not pneumonia.”
What that means is accurate diagnosis can cut the mortality rate of pneumonia down by 42%, but it involves a little more than just figuring out if a child, in fact, has pneumonia.
In order to properly treat pneumonia, health workers need to know the severity of it, whether it is viral, or bacterial, and decides if antibiotics need to be used or if a costly trip to the hospital is in order.
While this would be all fine and good here, the trouble is, these health workers need to be able to make these decisions and come to these conclusions accurately, and using minimal and basic equipment. Thankfully, Naydenova and her team think they found a solution.
Elina said: ‘For identifying pneumonia we found four features that can be measured with two pieces of equipment. Heart rate, respiratory rate and oxygen saturation can all be measured using a pulse oximeter. Temperature requires a thermometer. These are things that can be made available to a health worker with basic training.
‘Using these four measures, we achieved 98.2% sensitivity and 97.5% specificity [meaning, they could correctly identify 982 out of every 1000 pneumonia cases and only falsely identified pneumonia in 25 of every 1000 people without the disease], compared to IMCI, where the best performance is 94% sensitivity and 69% specificity.’
To most of us, these numbers could be a little confusing, but the application is real.
‘We have identified a set of features that could offer an alternative to the combination of X-rays and blood cultures only available in a well-equipped hospital. These will be used in a mobile application linked to a set low-cost diagnostic equipment, which we will be trialing in the next couple of years,’ says Naydenova.
All and all, this looks like it can save the lives of millions of children across the world, and all of this, and the costs are minimal. However, the reward of saving lives, that is quite large.