Combatting pneumonia using Philips ChARM monitor

Pneumonia causes more than 900,000 deaths annually among children under the age of 5, accounting for 16% of child mortality worldwide1.

Of these, 99% of deaths occur in developing countries in low-resource settings, typically rural areas with very limited or poor healthcare facilities or with low-skilled health workers.

 

With its commitment to address the UN’s Sustainable Development Goal 3 to improve health and wellbeing, Royal Philips and Grand Challenges Canada, funded by the Government of Canada, agreed to scale an innovation called ChARM. This is, a monitor which automatically detects respiratory rate in children under the age of 5 in order to improve the diagnosis of childhood pneumonia in low resource countries.

 

While significant gains have been made in eradicating common killers associated with child and maternal mortality, children still face an array of health issues. 

 

There are a total of 120 million episodes of pneumonia annually2, of which 14 million progressed to severe episodes. Pneumonia is one of the most solvable problems in global health, yet / still a child dies from the infection every 30 seconds. 

 

A high proportion of pneumonia deaths (81%) occur in the first two years of a child’s life, with the vast majority of deaths occurs in low-resource settings in developing countries, where diagnosis is poor - in many cases pneumonia is misdiagnosed as malaria – and treatment is not readily available.

 

Advanced diagnostic tools, such as chest x-rays and laboratory tests, are not available in low-resource health settings. Instead, health workers are trained to diagnose pneumonia by observing and counting how quickly a child’s chest rises and fall. But achieving an accurate count can be difficult, as shallow breaths are hard to detect, children often move around and there may be distractions and other checks to perform.

 

Anecdotally, experts believe that this method is subjective and inaccurate. Many studies have demonstrated clinically obtained measures to be inaccurate, lacking both reliability and reproducibility in a variety of health care settings.

 

“If we can remove the subjectivity associated with health workers counting breaths, we can improve the quality of treatment and help reduce the inappropriate use of antibiotics,” says Salim Sadruddin, Senior Child Health Advisor at Save the Children.

Innovating to save child lives

 

Through its ARIDA (Acute Respiratory Infection Diagnostic Aid) project UNICEF launched a Request for Expression of Interest in 2015 to encourage industry and academia to develop medical devices to address this problem3

 

Philips developed the Children’s Respiration Monitor (also known as ChARM), a monitor which automatically detects respiratory rates in children under the age of 5 and is affordable and accessible for community-based health workers working in difficult and remote conditions. 

ChARM helps community health workers establish a more accurate measurement of a sick child’s breathing rate to help improve the diagnosis of pneumonia and potentially prevent serious illness or death.

 

Reaching 100 million children a year

 

How does ChARM work? It is strapped around a child’s chest, without requiring direct skin contact. It delivers an accurate and reliable breathing rate measurement by converting chest movements detected by accelerometers into an accurate breathing count, using specially developed algorithms. 

The monitor not only provides quantitative feedback, but also qualitative feedback to the healthcare provider based on the World Health Organization’s IMCI4 (Integrated Management of Childhood Illness) guidelines to diagnose fast breathing rates, which is one of the key vital signs to diagnosing pneumonia.

 

In the hands of community health workers, the Philips ChARM can save and improve millions of lives: at scale more than 100 million children per year could receive more accurate pneumonia diagnosis supported with ChARM5 .

 

The long-lasting battery makes it power independent, suitable for areas without electricity. The device is dustproof, water-splashing proof and can be used in extreme temperatures. It is small and easily portable for use in community and clinical settings. The user interface is pictogram-based, designed to be intuitive and easy to use, suitable for providers with low literacy.

 

A commitment to sustainable health

 

The development of ChARM is part of the commitment made in Philips’ pledge to the Every Woman Every Child movement, to develop and deploy innovations that enable access and improve quality of care for mothers and their children in low‐resource settings. 

 

The promotion and scaling of such innovations are important to accelerate the implementation of the UN Global Strategy for Women's Children's and Adolescents' Health in support of the Sustainable Development Goals. ChARM, in particular, supports the Sustainable Development Goal 3, to ensure healthy lives and promote wellbeing. 

 

To further support sustainable health, Philips and Grand Challenges Canada, an organization focused on saving and improving lives around the world and funded by the government of Canada, signed an agreement to scale the manufacturing and distribution of ChARM, so it can reach more remote communities globally.

 

“Pneumonia is a killer of children especially in the developing world. ChARM responds to a crucial need to reduce deaths from childhood pneumonia. By collaborating with a large company such as Philips, we can help innovations to reach millions,” said Dr. Peter A. Singer, Chief Executive Officer of Grand Challenges Canada.

 

A CA$602,000 repayable grant, matched by Philips, has financed the market launch of ChARM and supports the development of the next generation of the device which is planned to include pulse oximetry & temperature. The agreement also aims to ensure global access in low- and middle-income countries.