ARIDA (Acute Respiratory Infection Diagnostic Aid)
The ARIDA project involves the development of handheld devices that accurately diagnose pneumonia in children.
The challenge
Pneumonia is the leading cause of death from infectious disease in children under five worldwide, linked to 15 per cent of all under five deaths. Every year, approximately 800,000 children under five die from pneumonia, many of which can be prevented through timely diagnosis and treatment.
However, accurate diagnosis is a major challenge and pneumonia is frequently misdiagnosed for other febrile illnesses, such as malaria or tuberculosis, which delays life-saving treatment.
The World Health Organization (WHO) international guidelines for diagnosing pneumonia in settings where advanced hospital equipment isn’t available is to count the respiratory rate (RR). However, counting breaths in children is difficult. The RR can alter depending on the environment and technique used by the person who counts which leaves space for human error that often leads to mis-diagnosing. Furthermore, there is no set definition of a breath, meaning it is not possible to validate when a breath has been counted correctly. In many cases, counting simply does not happen.
The job by frontline community health workers could be made easier and standardized with a device to support the assessment of children with pneumonia. Equipping them with an improved diagnostic aid can empower them to provide timely, appropriate treatment.
“All of the health workers we spoke to in many different countries said one of the hardest things they had to do was count breaths for pneumonia diagnosis. It’s very difficult to count breaths by just looking at a child.”
The response
With support from the la Caixa Banking Foundation, UNICEF’s Acute Respiratory Infection Diagnostic Aid (ARIDA) project involves the development of devices that aid in the classification and management of children with pneumonia. After the launch of the project in 2014, UNICEF worked with industry partners to develop two new products that were tested in Bolivia, Ethiopia and Nepal. The two products include:
- Philips ChARM (Children’s Automatic Respiratory Monitor) is an automated RR counter that straps around the child’s torso and counts the breaths while he/she is lying down.
- Masimo Rad G is a joint RR and oximetry device. This device provides additional medical information for health workers, including warning signals for when a child has dangerously low oxygen levels in the blood.
The impact
2 new devices
developed that count respiratory rate in children
1.3 million children
accessed treatment for pneumonia after diagnosis with new devices
6,175 health workers
trained and equipped with devices in Bolivia, Ethiopia and Nepal.
Over the course of three years, the project carried out four field studies and 11 implementation evaluations to test the usability and accuracy of the new products.
As a result, close to 1.3 million children accessed antibiotic treatment, more than 308,000 children benefitted from improved care and 6,175 health workers were trained and equipped in Bolivia, Ethiopia and Nepal.
By automatizing the counting of breaths through a simple hand-held device, community health workers are more likely to adhere to the WHO guidelines for counting breaths and make a more informed and rapid diagnosis of pneumonia. In addition, the use of portable pulse oximeters that identify children with severe pneumonia in urgent need of oxygen therapy can save lives. Both ARIDA devices support community workers who are often the first point of contact for children with pneumonia, allowing them to improve patient case management which will consequently reduce preventable child mortality.
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