OPT-bCPAP · Oxygen Optimization Therapy through BCPAP for management of childhood pneumonia in general hospitals of LMICs

Pneumonia is a leading cause of morbidity and mortality especially among children in sub-Saharan Africa. Nigeria and Ethiopia are among the 5 countries that account for half of the under-five pneumonia deaths. Majority of the deaths from pneumonia are however preventable with early diagnosis and appropriate management. In children with pneumonia, hypoxemia is quite common and constitutes a major risk factor for death. The WHO and other leading child health agencies urge widespread access to oxygen therapy. Bubble continuous positive airway pressure (bCPAP) is a method of delivering oxygen and positive pressure into the airways thus keeping the alveoli open for improved gas exchange. While use of bCPAP devices appears safe and effective worldwide, scaling of quality bCPAP devices in low- and middle-income countries (LMICs) has been limited. This has prevented most children in LMICs from receiving life-saving non-invasive respiratory support which could have saved many lives. Achieving Sustainable Development Goal (SDG) 3.2 of the reduction of under-5 mortality to at least as low as 25 per 1,000 live births by 2030 will likely not be possible without access to innovative and low cost interventions devices such as bCPAP in LMICs. The aim of the OPT-bCPAP is to perform context-appropriate scale-up of bCPAP in settings of very high disease burden (Nigeria, Ethiopia and Malawi) using the the positive results and the lessons learned from clinical trials conducted in Ethiopia, Bangladesh and Ghana. In addition to scaling up bCPAP, we will deeply explore additional factors associated with treatment failure and mortality from severe pneumonia, we aim to generate data on adherence to treatment guidelines, healthcare-seeking behaviour, magnitude of respiratory syncytial virus infection, antimicrobial resistance, PK/PD of commonly used antibiotics and generate novel recommendations for antibiotic treatments tailored to the populations in these diverse settings.