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<p>Lung auscultation is not included in the WHO Integrated Management of Childhood Illness algorithm, partly due to concerns regarding feasibility and reliability when performed by non-physician primary health workers in low-resource settings. In this feasibility study, we evaluated whether non-physician primary care health workers (community health care providers (CHCPs)) can record quality lung sounds from children aged 2–59 months. Feasibility was predefined as more than 50% of children having quality recordings at the overall sample level. After receiving three days of structured training, nine CHCPs recorded lung sounds from four chest positions using a digital stethoscope (Sonavi Labs, United States) in 990 children attending first-level rural clinics in Bangladesh between November 2019 and December 2020, with enrolment paused during the COVID-19 pandemic. A blinded paediatrician listening panel, trained to a standardised interpretation protocol, classified the recordings. A quality recording was defined a priori as the panel classifying three of four chest positions on a participant as interpretable. Lung sounds were recorded from 990 children, and the panel classified 867 children as having a quality recording (87.6%; 95% confidence interval: 85.4%, 89.6%). Among children with quality recordings and available timing data, 89.8% (766/853) were recorded within five minutes. This study demonstrates CHCPs at rural, first-level clinics in Bangladesh are capable of timely, quality recordings of lung sounds from most children using a digital stethoscope.</p>

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Digital stethoscope use by non-physician primary care health workers on children under five years of age in rural Bangladesh: a feasibility study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月12日

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  • Salahuddin Ahmed,
  • Harish Nair,
  • Steve Cunningham,
  • Ahad Mahmud Khan,
  • Md Shafiqul Islam,
  • ASMD Ashraful Islam,
  • Nabidul Haque Chowdhury,
  • Ian Mitra McLane,
  • Leah Githinji,
  • Mulindwa Makasa Justin,
  • Ismat Jahan,
  • Mohammad Wahiduzzaman,
  • Rezwana Tabassum,
  • Dipak Kumar Mitra,
  • Mohammod Shahidullah,
  • Abdullah H. Baqui,
  • Eric D. McCollum

摘要

Lung auscultation is not included in the WHO Integrated Management of Childhood Illness algorithm, partly due to concerns regarding feasibility and reliability when performed by non-physician primary health workers in low-resource settings. In this feasibility study, we evaluated whether non-physician primary care health workers (community health care providers (CHCPs)) can record quality lung sounds from children aged 2–59 months. Feasibility was predefined as more than 50% of children having quality recordings at the overall sample level. After receiving three days of structured training, nine CHCPs recorded lung sounds from four chest positions using a digital stethoscope (Sonavi Labs, United States) in 990 children attending first-level rural clinics in Bangladesh between November 2019 and December 2020, with enrolment paused during the COVID-19 pandemic. A blinded paediatrician listening panel, trained to a standardised interpretation protocol, classified the recordings. A quality recording was defined a priori as the panel classifying three of four chest positions on a participant as interpretable. Lung sounds were recorded from 990 children, and the panel classified 867 children as having a quality recording (87.6%; 95% confidence interval: 85.4%, 89.6%). Among children with quality recordings and available timing data, 89.8% (766/853) were recorded within five minutes. This study demonstrates CHCPs at rural, first-level clinics in Bangladesh are capable of timely, quality recordings of lung sounds from most children using a digital stethoscope.