Pulse oximetry and integrated management of childhood illness for diagnosis of childhood pneumonia in primary health care units of rural Ethiopia: study protocol for a cluster randomized controlled trial

Background: The World Health Organization¿s integrated management of childhood illness algorithm is currently used in resource limited countries for managing childhood pneumonia. However, this algorithm has limitation in accurately classifying children with pneumonia and in identifying children who are in need of oxygen therapy. Therefore, this study aimed to see if the introduction of pulse oximetry would improve the performance of health workers for diagnosing severe childhood pneumonia and the cost effectiveness of this intervention at primary health care units. Primary objectiveThe primary objective of this study is to compare whether the combined use of integrated management of childhood illness (IMCI) algorithm and pulse oximetry increases the proportion of severe pneumonia case detection, among children aged 2 month to 59 month, compared to integrated management of childhood illness algorithm only. Secondary objectivesThe secondary objectives of the study are:i. To determine whether combined use of IMCI algorithm and pulse oximetry increases the proportion of pneumonia cases referred to hospital. ii. To assess the treatment failure (up to 2, 5 and 14 days) after treatment with IMCI and pulse oximetry versus IMCI algorithm alone. iii. To estimate the incremental cost effectiveness of the combined use of IMCI algorithm and pulse oximetry with IMCI algorithm alone.