Survival Study for Children in Acute Respiratory Distress

Ghana

PROGRAM FACULTY: dr. rachel moresky, assistant professor population and family health and MEdicine

other cumc faculty: Dr. patrick wilson, assistant professor of pediatrics and population and family health; dr. Philip larussa, professor of pediatrics, dr. marilyn morris, associate professor of pediatrics

other co-investigators: Dr. frank baiden; dr. harry tagbor

The CPAP Ghana Survival Study is designed to measure the impact continuous positive airway pressure (CPAP), a low-cost, low-technology medical device, has on mortality in children 1 to 59 months of age presenting with acute respiratory distress in a low-resource setting. In 2011 sidHARTe’s  randomized controlled clinical trial evaluating nasal CPAP in pediatric patients aged  three months to five years in acute respiratory distress was performed in four rural hospitals in Ghana. The study found patients receiving CPAP had a significant decrease in respiratory rate compared with those that did not. There were no major side effects associated with the use of CPAP. Having demonstrated CPAP decreased respiratory rate in a population presenting with undifferentiated respiratory distress we set out to determine if CPAP could also improve survival and to more accurately define the etiology of respiratory distress.  This led to our current CPAP survival: ClinicalTrials.gov.

The emergency wards of two district hospitals located in the Brong-Ahafo and Ashanti regions of Ghana serve as the trial sites. To date 2,188 participants have been enrolled in the study with a target enrolment of 2,200. Secondary outcomes include improvement in respiratory rate in children receiving CPAP compared with those who do not and identifying the etiology of respiratory distress using multiplex PCR for viral respiratory pathogens and rapid malaria antigen testing. The results of the study will be available in early 2016 with the ultimate goal of contributing to the prevention of deaths in neonatal, infant and pediatric patients on a global scale. The CPAP Ghana Survival Study is a collaborative effort between Columbia University, Ghana Health Service, Center for Global Health Research, Ghana and the Kwame Nkrumah School of Science and Technology (KNUST).

REPORTS: Forthcoming