Overview

The publication provides a summary of evidence and assessment using the GRADE process, and recommendations on the management of common causes of childhood illnesses. The key areas covered include management of several common neonatal conditions, common causes of fever (acute and chronic otitis media, typhoid fever and meningitis); treatment of acute respiratory infections; treatment of dysentery; use of antibiotics in severe acute malnutrition; use and delivery of oxygen therapy in children; and supportive care.

These priority areas were the basis of the evidence review, and synthesis and development of these revised recommendations with a focus on settings with limited health systems capacity and resources. WHO has developed the present evidence-informed recommendations with a view to promoting the best possible clinical practices that consider the risks and benefits, acceptability, feasibility, cost and other resource implications.

Target audience: the recommendations are aimed at policy makers, national guidelines committees, and programme managers, as well as health-care professionals providing paediatric in both outpatient and inpatient settings.

Contents

• Abbreviations
• Acknowledgements
• Executive summary
• 1. Introduction
  • 1.1 Target audience
  • 1.2 Objectives of the recommendations
  • 1.3 Financial support
  • 1.4 Management of conflict of interest
  • 1.5 Guiding principles
• 2. Methodology and process
  • 2.1 Defining the scope
  • 2.2 Evidence retrieval and synthesis process
  • 2.3 Consensus building and external peer review
  • 2.4 Review and update of the recommendations
• 3. Implementation of the recommendations
  • 3.1 Proposed subsidiary products
  • 3.2 Implementation of the recommendations
  • 3.3 National adaptation and implementation
• 4. Recommendations
  • Recommendations for management of newborn conditions
  • Recommendations for treatment of cough and difficulty in breathing
  • Recommendations for treatment of dysentery
  • Recommendations for treatment of common causes of fever
  • Recommendation for use of antibiotics in severe acute malnutrition
  • Recommendations on Use and Delivery of Oxygen Therapy
  • Recommendations on treatment of hypoglycaemia
  • Recommendations on the choice of intravenous fluids
• 5. Evidence for recommendations on the newborn conditions
  • 5.1 Vitamin K prophylaxis in newborns
  • 5.2 Prophylactic antibiotics in newborns at risk of infection
  • 5.3 Skin-to-skin contact in the first hour of life
  • 5.4 Management of neonatal jaundice
  • 5.5 Empirical antibiotics for suspected neonatal sepsis
  • 5.6 Head or whole body cooling in management of hypoxic ischaemic encephalopathy
  • 5.7 Antibiotics for treatment of necrotizing enterocolitis
  • 5.7.1 Evidence and summary of findings
  • 5.7.2 Benefits and risks
  • 5.7.3 Acceptability and feasibility
  • 5.8 Kangaroo Mother Care
  • 5.9 Prevention of hypothermia immediately after birth in low birth weight infants
• 6. Evidence for recommendations for treatment of pneumonia
  • 6.1 Antibiotic treatment for non-severe pneumonia with wheeze
  • 6.2 Antibiotic treatment for non-severe pneumonia with no wheeze
  • 6.3 Antibiotics treatment for severe pneumonia
  • 6.4 Antibiotics treatment for very severe pneumonia
  • 6.5 Salbutamol for treatment of acute wheeze/asthma and bronchoconstriction
• 7. Evidence for recommendations for treatment of dysentery
  • 7.1 Antibiotics for treatment of dysentery
• 8. Evidence for recommendations on treatment of fever conditions
  • 8.1 Antibiotics for treatment of acute bacterial meningitis
  • 8.2 Antibiotic treatment for Acute Otitis Media (AOM)
  • 8.3 Antibiotic treatment for Chronic Suppurative Otitis Media (CSOM)
  • 8.4 Topical antiseptics for treatment of Chronic Suppurative Otitis Media (CSOM)
  • 8.5 Topical steroids for treatment of Chronic Suppurative Otitis Media (CSOM)
  • 8.6 Antibiotic treatment for Typhoid Fever
• 9. Evidence for recommendation on use of antibiotics in SAM
  • 9.1 Antibiotics use in the management of severe acute malnutrition
• 10. Evidence for recommendations on the oxygen use and delivery
  • 10.1 Pulse oximetry for detection of hypoxaemia
  • 10.2 Clinical signs in detection of hypoxaemia in children
  • 10.3 Oxygen therapy in treatment of hypoxaemia
  • 10.4 Thresholds for administering oxygen therapy
  • 10.5 Oxygen therapy delivery methods
  • 10.6 Criteria for starting and stopping oxygen therapy
• 11. Evidence for Recommendations for Treatment of Hypoglycaemia
  • 11.1 Sublingual administration of sugar in treatment of hypoglycaemia
• 12. Evidence for recommendations on the choice of intravenous fluids
  • 12.1 Choice of intravenous fluids for resuscitation and maintenance in children
• 13. Outline of the research gaps
  • 13.1 Vitamin K prophylaxis in newborns
  • 13.2 Prophylactic antibiotics to neonates with risk factors for infection
  • 13.3 Skin-to-skin contact in the first hour of life
  • 13.4 Management of neonatal jaundice
  • 13.5 Kangaroo Mother Care
  • 13.6 Prevention of hypothermia immediately after birth in VLBW infants
  • 13.7 Management of children with non-severe pneumonia and wheeze
  • 13.8 Antibiotics for severe pneumonia
  • 13.9 Antibiotics for very severe pneumonia
  • 13.10 Treatment of non-severe pneumonia
  • 13.11 Antibiotics for Meningitis
  • 13.12 Antibiotics for Acute Otitis Media
  • 13.13 Antibiotics for Typhoid Fever
  • 13.14 Antibiotics for severe acute malnutrition
  • 13.15 Oxygen systems and delivery methods
  • 13.16 Pulse oximetry
  • 13.17 Thresholds for giving oxygen
• Annexes
  • ANNEX 1 Overview of the Pocket Book chapter update
  • ANNEX 2 List of PICO questions
  • ANNEX 3 Members of expert panel, expertise and affiliations
  • ANNEX 4 List of external reviewers
  • ANNEX 5 Members of the WHO Guideline Steering Group
  • ANNEX 6 Tables
  • ANNEX 7 GRADE Evidence tables
• References

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