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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Feasibility of Training Clinical Officers in Point-of-Care Ultrasound for Pediatric Respiratory Diseases in Aweil, South Sudan
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Feasibility of Training Clinical Officers in Point-of-Care Ultrasound for Pediatric Respiratory Diseases in Aweil, South Sudan

机译：南苏丹Aweil小儿呼吸道疾病培养临床官员培训临床官员的可行性

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摘要

Lower respiratory tract infections (LRTIs) are the leading cause of deaths in children <5 years old worldwide, particularly affecting low-resource settings such as Aweil, South Sudan. In these settings, diagnosis can be difficult because of either lack of access to radiography or clinical algorithms that overtreat children with antibiotics who only have viral LRTIs. Point-of-care ultrasound (POCUS) has been applied to LRTIs, but not by nonphysician clinicians, and with limited data from low-resource settings. Our goal was to examine the feasibility of training the mid-level provider cadre clinical officers (COs) in a Medecins Sans Frontieres project in South Sudan to perform a POCUS algorithm to differentiate among causes of LRTI. Six COs underwent POCUS training, and each subsequently performed 60 lung POCUS studies on hospitalized pediatric patients < 5 years old with criteria for pneumonia. Two blinded experts, with a tiebreaker expert adjudicating discordant results, served as a reference standard to calculate test performance characteristics, assessed image quality and CO interpretation. The COs performed 360 studies. Reviewers rated 99.1% of the images acceptable and 86.0% CO interpretations appropriate. The inter-rater agreement (.) between COs and experts for lung consolidation with air bronchograms was 0.73 (0.63-0.82) and for viral LRTI/bronchiolitis was 0.81 (0.74-0.87). It is feasible to train COs in South Sudan to use a POCUS algorithm to diagnose pneumonia and other pulmonary diseases in children < 5 years old.
机译：降低呼吸道感染（LRTIS）是儿童死亡事业<5岁全世界，特别是影响低资源环境，如AWEIL，南苏丹。在这些设置中，诊断可能是困难的，因为缺乏对仅具有患有病毒性LRTIS的抗生素的儿童的射线照相或临床算法。护理点超声（POCUS）已应用于LRTIS，但不是非物理学临床医生，以及来自低资源设置的有限数据。我们的目标是审查培训中级提供者干部临床官员（COS）在南苏丹的Medecins Sans Frontieres项目中进行培训，以执行PoCus算法，以区分LRTI的原因。六COS接受了POCUS训练，每次随后对住院儿科患者进行了60例肺POCUS研究<5岁，具有肺炎标准。两个盲目的专家，具有裁员不和谐的结果，作为参考标准来计算测试性能特征，评估图像质量和共同解释。 COS进行了360项研究。审核人员评定了99.1％的图像可接受和86.0％的共同解释适当。使用空气支气管图的肺部整合的COS和专家之间的帧间间协定（。）为0.73（0.63-0.82）和病毒LRTI /支气管炎为0.81（0.74-0.87）。在南苏丹培训COR在南苏丹培训，可以使用POCUS算法来诊断肺炎和儿童其他肺病<5岁。

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