Management of neonatal jaundice

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13.5 Kangaroo Mother Care

1. Implementation, scaling up issues 2. Ongoing KMC at home post-discharge, feasibility, how long to continue 3. Efectiveness, feasibility of early community initiation of KMC

13.6 Prevention of hypothermia immediately after birth in VLBW infants

1. he group recommended an RCT of plastic wraps for VLBW babies in district and provincial hospitals in developing country settings

13.7 Management of children with non-severe pneumonia and wheeze

1. Studies on withholding antibiotics in young children with wheeze, no fever and non-severe pneumonia need to be replicated in other settings, including health workers ability to identify these children at very low risk of bacterial infection, and the acceptability of withholding antibiotics 2. Studies testing accuracy of diferent diagnostic algorithms for pneumonia and deinitions of treatment failure

13.8 Antibiotics for severe pneumonia

1. More data is needed to assess appropriate antibiotic therapy of severe pneumonia in high HIV settings 2. More research is needed on ambulatory care for severe pneumoniarequisites for safely treating such children at home or in day clinic settings 3. Research in moderately malnourished children with pneumonia 4. Repeat the clinical trials for treatment outcomes in countries with high Hib and pneumococcal vaccine coverage.

13.9 Antibiotics for very severe pneumonia

1. Data on shits in bacterial patterns due to coverage of H. inluenzae type b and S. pneumococcus vaccines and implications for treatment of pneumonia and antimicrobial resistance 2. Comparison of the recommended treatment injectable ampicillin or penicillin and gentamicin versus injectable cetriaxone 3. What should be second line therapy for children failing on irst line therapy? 4. Impact of improved comprehensive care packages on outcomes for children with very severe pneumonia.

13.10 Treatment of non-severe pneumonia

1. Studies to determine the duration of therapy in settings other than Asia 2. Repeat the clinical trials for treatment outcomes in countries with high Hib and pneumococcal vaccine coverage 3. Research on treatment failure deinition, and choice of second line treatment 4. Research on increasing speciicity of pneumonia diagnosis and aetiology of pneumonia 83

13.11 Antibiotics for Meningitis

1. here is need for comparative studies on dose and frequency of cetriaxone, 2. Improved surveillance for antibiotic resistance among pathogens causing meningitis 3. he role and accuracy of rapid point of care diagnostic tests, that can be used in district hospitals that do not have culture facilities 4. Studies of the aetiology on meningoencephalitis in settings with high coverage of SPHib vaccine coverage

13.12 Antibiotics for Acute Otitis Media

1. RCTs in developing countries with pragmatic deinition of otitis 2. Follow up studies in developing countries to quantify complication rates, especially in high prevalence HIV settings 3. Systematic review of treatment of otorrhoea as may merit separate guidelines 4. RCT of diferent durations of antibiotic treatment including BD versus TID

13.13 Antibiotics for Typhoid Fever

1. Develop point of care diagnostic tests with higher speciicity than current tests 2. Deine local resistance patterns 3. Studies of basic epidemiology of typhoid in Africa 4. Continuing need for efective vaccine

13.14 Antibiotics for severe acute malnutrition

1. he role of metronidazole in controlling intestinal bacterial overgrowth in children with Severe Acute Malnutrition? here is currently one ongoing trial in Senegal 2. he efectiveness of diferent antibiotic regimens in the treatment of complicated SAM. 3. A randomised controlled trial on the role of antibiotics in uncomplicated SAM.

13.15 Oxygen systems and delivery methods

1. Large-scale efectiveness trials of improved oxygen systems on outcomes from pneumonia 2. Studies of alternative power supplies to run oxygen concentrators and pulse oximeters in remote settings where power supplies are unreliable 3. he role of inexpensive forms of CPAP in the management of severe pneumonia 4. Are there safe methods for cleaning and reuse of oxygen delivery equipment in high HIV prevalence settings?

13.16 Pulse oximetry

1. Studies of diferent types of pulse oximetry – such as hand-held devices – in ield settings