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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

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.38915.673322.80 (Published 21 September 2006) Cite this as: BMJ 2006;333:629
  1. Tabish Hazir (arichi99{at}ariresearch.edu.pk), principal investigator1,
  2. Yasir Bin Nisar, research administrator1,
  3. Shamim A Qazi, medical officer3,
  4. Shazia F Khan, associate professor2,
  5. Mujahid Raza, assistant professor2,
  6. Shehla Zameer, assistant professor2,
  7. Syed Asif Masood, medical officer4
  1. 1 ARI Research Cell, Children's Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan,
  2. 2Department of Radiology, Pakistan Institute of Medical Sciences,
  3. 3Department of Child and Adolescent Health and Development, World Health Organization, Geneva, Switzerland,
  4. 4Department of Paediatrics, Aga Khan University Hospital, Karachi, Pakistan
  1. Correspondence to: T Hazir
  • Accepted 5 July 2006

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.

Footnotes

  • Contributors TH helped develop the protocol, implement and monitor the study, analyse the data, and write the manuscript. YBN helped implement and monitor the study, analyse the data, and write the manuscript. SAQ helped develop the protocol, monitor the study, analyse the data, and write the manuscript. SFK and MR read all the chest radiographs. SZ read all the disputed radiographs. SAM helped write the manuscript. TH is guarantor.

  • Funding Department of Child and Adolescent Health and Development, World Health Organization (WHO), Geneva.

  • Competing interests None declared.

  • Ethical approval: Institutional ethical review boards of Pakistan Institute of Medical Sciences, Islamabad, Pakistan, and the secretariat committee on research involving human subjects, World Health Organization, Geneva.

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