Chest radiography in children aged 2-59 months diagnosed with non-severe pneumonia as defined by World Health Organization: descriptive multicentre study in Pakistan

doi:10.1136/bmj.38915.673322.80

BMJ 2006;333:629 (23 September), doi:10.1136/bmj.38915.673322.80 (published 21 August 2006)

Research

Chest radiography in children aged 2-59 months diagnosed with non-severe pneumonia as defined by World Health Organization: descriptive multicentre study in Pakistan

Tabish Hazir, principal investigator¹, Yasir Bin Nisar, research administrator¹, Shamim A Qazi, medical officer³, Shazia F Khan, associate professor², Mujahid Raza, assistant professor², Shehla Zameer, assistant professor², Syed Asif Masood, medical officer⁴

¹ ARI Research Cell, Children's Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, ² Department of Radiology, Pakistan Institute of Medical Sciences, ³ Department of Child and Adolescent Health and Development, World Health Organization, Geneva, Switzerland, ⁴ Department of Paediatrics, Aga Khan University Hospital, Karachi, Pakistan

Correspondence to: T Hazir arichi99{at}ariresearch.edu.pk

Abstract

Objectives To evaluate the chest radiographs of children diagnosedwith non-severe pneumonia on the basis of the current WorldHealth Organization guidelines (fast breathing alone) for radiologicalevidence of pneumonia.

Design Descriptive analysis.

Setting Outpatient departments of six hospitals in four citiesin Pakistan.

Participants 2000 children with non-severe pneumonia were enrolled;1932 children were selected for chest radiography.

Interventions Two consultant radiologists used standardisedWHO definitions to evaluate chest radiographs; no clinical informationwas made available to them. If they disagreed, the radiographswere read by a third radiologist; the final classification wasbased on agreement between two of the three radiologists.

Main outcome measures Presence or absence of pneumonia on radiographs.

Results Chest radiographs were reported normal in 1519 children(82%). Radiological evidence of pneumonia was reported in only263 (14%) children, most of whom had interstitial pneumonitis.Lobar consolidation was present in only 26 children. The durationof illness did not correlate significantly with the presenceof radiological changes (relative risk 1.17, 95% confidenceinterval 0.91 to 1.49).

Conclusion Most children diagnosed with non-severe pneumoniaon the basis of the current WHO definition had normal chestradiographs.

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fast breathing and x-ray chest: Jayendra R Gohil, et al.
bmj.com, 22 Aug 2006 [Full text]
"Pneumonia": Sanjiv Lewin
bmj.com, 22 Sep 2006 [Full text]
Chest radiography in children aged 2-59 months diagnosed with non-severe pneumonia as defined by World Health Organization: descriptive multicentre study in Pakistan: Tabish Hazir, et al.
bmj.com, 23 Sep 2006 [Full text]
Childhood pneumonia in developing countries.: David A Green
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simple but effective algorithm needed: vijayashankara Nanjegowda
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