Monday 9 March 2020

The Children’s Oxygen Administration Strategy Trial (COAST) began in February 2017. It was designed to help children with pneumonia to receive the best possible treatment and have the best chance of survival. Pneumonia is one of the main causes of death in young children in Africa.

Following a recommendation by the independent Trial Steering Committee that it was not feasible for the trial to continue to its conclusion, the trial ended in February 2020. The trial had been halted and restarted several times in Uganda as a result of a campaign that called the trial’s safety into question, and this disruption ultimately made it difficult for the trial team to carry on with their work.

The trial was regularly reviewed by an independent Data and Safety Monitoring Board, which conducted four detailed reviews, each finding there were no safety concerns and recommending that the trial should continue. The mortality rate for children enrolled in the trial, as analysed by the Data and Safety Monitoring Board, was significantly lower than would be expected for children receiving hospital treatment for pneumonia in Africa. The trial had also been through rigorous scientific and ethical review, obtaining the necessary ethical approvals from three major ethics committees in the UK, Uganda and Kenya. 

By the time it ended the trial had enrolled 1,841 children, making it the largest trial of its kind ever conducted in children. Researchers and doctors collected important data that will now help them to work out the best way of treating children with pneumonia. In the coming months, the trial team expect to analyse the findings from the trial and publish these results.

Professor Kath Maitland, the Principal Investigator of the COAST trial from the Department of Infectious Diseases at Imperial College London, who is based in East Africa, said: “We are sad that the trial has ended sooner than we originally planned, but the work that we have already done has given us really valuable data. We hope that ultimately this work will lead to the best possible treatment for children with pneumonia. I would like to thank all the researchers and doctors who have worked so hard on this trial. I am also profoundly grateful to all the children who took part in it, and their families, for their contribution to this important work.” 

For further information, please contact Professor Kath Maitland: k.maitland@imperial.ac.uk