NIHR Global Health Research Unit on Respiratory Health (RESPIRE)

Salahuddin Ahmed

Project: Community use of digital auscultation to improve diagnosis of paediatric pneumonia in Sylhet, Bangladesh (Embedded PhD project)

PhD overview

  • Acute or chronic:  Acute
  • Country:  Bangladesh
  • Based at:  Projahnmo Research Foundation
  • Start date:  01 April 2018
  • End date:  31 March 2020
  • Supervisors:  Harish Nair, Steve Cunningham,  Abdullah Baqui, Eric McCollum
  • Email:  S.Ahmed-18@sms.ed.ac.uk
Salahuddin Ahmed Headshot
RESPIRE PhD student: Salahuddin Ahmed

Background

Integrated Community Case Management (iCCM) is a World Health Organization (WHO) approach in which community health workers deliver basic healthcare services in the community setting, including childhood pneumonia treatment.

The WHO pneumonia guidelines are sensitive but non-specific in order to ensure that children with possible pneumonia receive antibiotic treatment. As a result, while the guidelines miss few children with pneumonia (high sensitivity), many children who do not have pneumonia incorrectly receive antibiotics (low specificity), resulting in antibiotic overuse.

The WHO guidelines do not include lung auscultation (listening to lung sounds) in their pneumonia definition for frontline healthcare workers, likely due to its high inter-observer variability and subjectivity, regardless of healthcare providers training level. Digital auscultation by electronic stethoscopes may overcome these limitations.

Aim and impact

This study aims to improve the diagnostic accuracy of child pneumonia by using automated lung sound classification through digital auscultation. My PhD is part of a wider RESPIRE project on digital auscultation.

My PhD will use the study data to (i) assess the consistency of lung sounds recorded by primary health care workers from under-five children using a digital stethoscope against pre-defined quality thresholds and (ii) determine the reliability and performance of the interpretations of recorded lung sounds by the Smartscope analysis system compared to reference interpretations by a paediatric listening panel.

By achieving the study goals, in the future community-level healthcare providers will be able to more accurately diagnose respiratory disease among children in LMICs. Improved accuracy of respiratory diagnosis holds the potential of markedly improving respiratory treatment decision-making in the community where most children first access respiratory care.

Find out more about the wider digital auscultation project

Publications

Systematic review of clinical effectiveness, components, and delivery of pulmonary rehabilitation in low-resource settings. 

Habib, G.M., Rabinovich, R., Divgi, K., Ahmed, S., Saha, S.K., Singh, S., Uddin, A., Uzzaman, M.N., Pinnock, H.

npj Prim. Care Respir. Med. 30, 52 (2020).  

About me

I’ve been working with Johns Hopkins University (JHU) and Projahnmo Research Foundation (PRF) since 2007 as Coordinator/Director, managing all Projahnmo research projects in Bangladesh. I have played an active role in coordinating and leading several public health projects aimed to reduce maternal, neonatal and child morbidity and mortality.

I completed my MBBS degree from the University of Dhaka, Bangladesh in 1998 and have since completed a range of training. For example, training in epidemiology, biostatistics, data analysis and manuscript writing from Johns Hopkins University and the University of Cambridge. I have more than 25 publications in peer-reviewed journals. 

Three-Minute Thesis-Style Video Competition

For the RESPIRE ASM Showcase on the 24th November 2020, the RESPIRE PhD students recorded videos explaining their research, as part of a Three-Minute Thesis-Style Video Competition. Watch Salahuddin's presentation below.

Video: AHMED, Salahuddin
RESPIRE 3-Minute Thesis-Style Video Competition - AHMED, Salahuddin: Community use of digital auscultation to improve diagnosis of childhood pneumonia in Sylhet, Bangladesh