According to the WHO, in 2015, pneumonia accounted for 16% of deaths of children under five, with Sub-Saharan Africa and South Asia bearing the highest burden of disease among children.
Children with pneumonia have a range of symptoms such as fever, rapid breathing, coughing and sometimes difficulty breathing.
“Most mothers were able to accurately count their child’s respiratory rate using the beads and recognize other signs of pneumonia.”
Daniel Ansong, Kwame Nkrumah University of Science and Technology, Ghana
Lead researcher Daniel Ansong says the project aims to assess socio-cultural understanding of pneumonia and women’s level of confidence in counting respiratory rates and detecting signs of pneumonia.
A multidisciplinary research team and a local bead designer created the beads using materials such as twisted nylon string and heat-pressed polyester flags. The team sought the advice of women’s and children’s health experts to help refine the pearls.
The beads are similar to those used locally for religious purposes among Catholics and Muslims, which makes them culturally acceptable, says Ansong, a senior lecturer in the School of Medical Sciences at the University of Science and Technology. Kwame Nkrumah, Ghana.
Ansong adds that the project was implemented with 10,000 USD funding from the Danish International Development Agency as part of the Building Stronger Universities initiative.
The team piloted the concept by recruiting 100 postpartum women attending child protection clinics at Komfo Anokye Teaching Hospital (KATH), Ghana.
The team also used videos to educate mothers on using the beads and provided one-minute hourglasses to help users count breath rates, Ansong said, in an interview with SciDev.Net last month (May 30).
The intervention was implemented from July to September 2016, with assessments four and eight weeks after the training.
“Most of the mothers were able to accurately count their child’s respiratory rate using the beads and recognize other signs of pneumonia,” Ansong said.
Evans Xorse Amuzu, a research assistant at KATH who participated in the project, adds, “After eight weeks, approximately 85% of mothers had accurately counted respiratory rates using the beads.”
Francis Adjei Osei, project manager at the Kumasi Collaborative Research Center, KNUST, who worked on the project, explains that the interpretation of the color code used to design the beads is similar to that of traffic lights.
The beads of different colors are operated on the assumption that if a mother is able to count a child’s respiratory rate with the beads and it falls into the green zone for a particular age, then that is normal. If the count falls into the yellow, it is higher than normal and the mother should count again and observe.
If the respiratory rate falls into the red zone, the mother should recount the child’s respiratory rate and if after several counts it remains in the red zone, the mother should go to the hospital. The ambulance sign in the design tells the mother what needs to be done, that is, to take the child to the hospital after the count falls in the red bead area repeatedly.
“Red that communicates ‘stop’ (danger) represents a dangerous breath count in our design. Green that communicates ‘do’ (no danger) represents a good breath count. Yellow, which communicated caution, represents a potentially dangerous breath count that requires more regular monitoring,” he says.
The investigators intend to expand the intervention to allow them to establish the effectiveness of the intervention in a larger population.
Kofi Mensah Boateng, a doctor at Manna Mission Hospital in Accra, Ghana, says SciDev.Net that using the beads to diagnose pneumonia could help reduce clinicians’ workload in managing pneumonia, as mothers only refer children who need care to health facilities, thus providing enough time for clinicians to care for critically ill children.
According to Boateng, the initiative should be incorporated into World Pneumonia Day which is held annually on November 12 and is celebrated in Ghana to help educate new mothers and fight the disease.
This piece was produced by the UK Sub-Saharan Africa office of SciDev.Net.