Chest Radiograph Findings in Childhood Pneumonia Cases From the Multisite PERCH Study

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Fancourt, Nicholas ; Deloria Knoll, Maria ; Baggett, Henry C. ; Brooks, W. Abdullah ; Feikin, Daniel R. ; Hammitt, Laura L. ; Howie, Stephen R. C. ; Kotloff, Karen L. ; Levine, Orin S. ; Madhi, Shabir A. ; Murdoch, David R. ; Scott, J. Anthony G. ; Thea, Donald M. ; Awori, Juliet O. ; Barger-Kamate, Breanna ; Chipeta, James ; DeLuca, Andrea N. ; Diallo, Mahamadou ; Driscoll, Amanda J. ; Ebruke, Bernard E. ; Higdon, Melissa M. ; Jahan, Yasmin ; Karron, Ruth A. ; Mahomed, Nasreen ; Moore, David P. ; Nahar, Kamrun ; Naorat, Sathapana ; Ominde, Micah Silaba ; Park, Daniel E. ; Prosperi, Christine ; wa Somwe, Somwe ; Thamthitiwat, Somsak ; Zaman, Syed M. A. ; Zeger, Scott L. ; O’Brien, Katherine L.
• Corporate Authors:
  for the PERCH Study Group O’BrienKatherine L.LevineOrin S.KnollMaria DeloriaFeikinDaniel R.DeLucaAndrea N.DriscollAmanda J.FancourtNicholasFuWeiHammittLaura L.HigdonMelissa M.KaguciaE. WangeciKarronRuth A.LiMengyingParkDaniel E.ProsperiChristineWuZhenkeZegerScott L.WatsonNora L.CrawleyJaneMurdochDavid R.BrooksW. AbdullahEndtzHubert P.ZamanKhalequGoswamiDoliHossainLokmanJahanYasminAshrafHasanHowieStephen R. C.EbrukeBernard E.AntonioMartinMcLellanJessicaMachukaEuniceShamsulArifinZamanSyed M.A.MackenzieGrantScottJ. Anthony G.AworiJuliet O.MorpethSusan C.KamauAliceKazunguSidiOmindeMicah SilabaKotloffKaren L.TapiaMilagritos D.SowSamba O.SyllaMamadouTambouraBoubouOnwuchekwaUmaKouroumaNanaToureAliouMadhiShabir A.MooreDavid P.AdrianPeter V.BaillieVicky L.KuwandaLocadiahMudauAzwifarwiGroomeMichelle J.MahomedNasreenBaggettHenry C.ThamthitiwatSomsakMaloneySusan A.BunthiCharatdaoRhodesJuliaSawatwongPongpunAkarasewiPasakornTheaDonald M.MwananyandaLawrenceChipetaJamesSeidenbergPhilMwansaJameswa SomweSomweKwendaGeoffrey
• Description:
  Background.
  
  Chest radiographs (CXRs) are frequently used to assess pneumonia cases. Variations in CXR appearances between epidemiological settings and their correlation with clinical signs are not well documented.
  
  Methods.
  
  The Pneumonia Etiology Research for Child Health project enrolled 4232 cases of hospitalized World Health Organization (WHO)–defined severe and very severe pneumonia from 9 sites in 7 countries (Bangladesh, the Gambia, Kenya, Mali, South Africa, Thailand, and Zambia). At admission, each case underwent a standardized assessment of clinical signs and pneumonia risk factors by trained health personnel, and a CXR was taken that was interpreted using the standardized WHO methodology. CXRs were categorized as abnormal (consolidation and/or other infiltrate), normal, or uninterpretable.
  
  Results.
  
  CXRs were interpretable in 3587 (85%) cases, of which 1935 (54%) were abnormal (site range, 35%–64%). Cases with abnormal CXRs were more likely than those with normal CXRs to have hypoxemia (45% vs 26%), crackles (69% vs 62%), tachypnea (85% vs 80%), or fever (20% vs 16%) and less likely to have wheeze (30% vs 38%; all P < .05). CXR consolidation was associated with a higher case fatality ratio at 30-day follow-up (13.5%) compared to other infiltrate (4.7%) or normal (4.9%) CXRs.
  
  Conclusions.
  
  Clinically diagnosed pneumonia cases with abnormal CXRs were more likely to have signs typically associated with pneumonia. However, CXR-normal cases were common, and clinical signs considered indicative of pneumonia were present in substantial proportions of these cases. CXR-consolidation cases represent a group with an increased likelihood of death at 30 days post-discharge.
  
  
• Subjects:
  Child, Preschool Child Health Female Humans Infant Infant, Newborn Internationality Male Pneumonia Pneumonia, Bacterial Pneumonia, Viral Radiography, Thoracic

  More +
• Source:
  Clin Infect Dis. 2017; 64(Suppl 3):S262-S270.
• Pubmed ID:
  28575361
• Pubmed Central ID:
  PMC5447837
• Document Type:
  Journal Article
• Name as Subject:
  World Health Organization
• Place as Subject:
  Australia ; Bangladesh ; Gambia ; Kenya ; Mali ; South Africa ; Thailand ; Zambia
• Volume:
  64
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:56c52f15434ff9d420429dfc282cc9f3dd87451f2d19047ae4b3f386d1563098
• Download URL:
  https://stacks.cdc.gov/view/cdc/46185/cdc_46185_DS1.pdf
• File Type:
  [PDF - 428.60 KB ]