A cross-sectional study of point-of-care lactate testing in integrated community care management (ICCM) for children with acute respiratory illness in rural uganda

Authors: Michael Matte, Natsumi Koyama, Dana Giandomenico, Emmanuel Baguma, Georget Kibaba, Moses Ntaro, Raquel Reyes, Edgar M Mulogo, Ross M Boyce, Emily J Ciccone

Integrated community case management (iCCM) relies on village health workers (VHWs) to assess sick children and refer severe cases. A study in rural Uganda tested if measuring lactate levels, a marker of severe illness, could improve referrals. Among 204 children with fever and cough, 12% had elevated lactate levels, but these were often not linked to visible danger signs used in iCCM guidelines. This suggests that some severe illnesses may be missed, highlighting a potential gap in current assessment methods.