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 diagnosed with non-severe pneumonia on the basis of the current World Health Organization guidelines (fast breathing alone) for radiological evidence of pneumonia.

Design Descriptive analysis.

Setting Outpatient departments of six hospitals in four cities in Pakistan.

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

Interventions Two consultant radiologists used standardised WHO definitions to evaluate chest radiographs; no clinical information was made available to them. If they disagreed, the radiographs were read by a third radiologist; the final classification was based 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 only 263 (14%) children, most of whom had interstitial pneumonitis. Lobar consolidation was present in only 26 children. The duration of illness did not correlate significantly with the presence of radiological changes (relative risk 1.17, 95% confidence interval 0.91 to 1.49).

Conclusion Most children diagnosed with non-severe pneumonia on the basis of the current WHO definition had normal chest radiographs.


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fast breathing and x-ray chest
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bmj.com, 22 Aug 2006 [Full text]
"Pneumonia"
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