Skip to main content
Bulletin of the World Health Organization logoLink to Bulletin of the World Health Organization
. 1994;72(1):113–118.

Clinical signs of pneumonia in children attending a hospital outpatient department in Lesotho.

S C Redd 1, R Vreuls 1, M Metsing 1, P H Mohobane 1, E Patrick 1, M Moteetee 1
PMCID: PMC2486503  PMID: 8131246

Abstract

To determine the value of clinical findings for the diagnosis of pneumonia, we evaluated 950 children who presented with respiratory illness to the outpatient department of the Queen Elizabeth II Hospital, Maseru, Lesotho. Those children at high risk for pneumonia and a systematically selected 20% sample of children at low risk were examined in turn by a nurse, a general practitioner, and a paediatrician; a chest radiograph was recorded for each child. Pneumonia was defined as radiographic findings compatible with the disease as interpreted by a paediatric radiologist. A respiratory rate > or = 50 breaths/minute was a sensitive sign for pneumonia among infants (sensitivity range for the three examiners: 59-79%), but identified a progressively smaller proportion of children with pneumonia in older age groups. Adjusting the respiratory rate for age using a threshold of > or = 40 breaths/minute for children aged > or = 12 months improved the sensitivity, but identified < 30% of children with pneumonia aged > or = 24 months. No drop in sensitivity with age was found when respiratory rate thresholds were evaluated for children with more severe radiographic evidence of pneumonia.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Begg C. B. Methodologic standards for diagnostic test assessment studies. J Gen Intern Med. 1988 Sep-Oct;3(5):518–520. doi: 10.1007/BF02595932. [DOI] [PubMed] [Google Scholar]
  2. Campbell H., Byass P., Greenwood B. M. Simple clinical signs for diagnosis of acute lower respiratory infections. Lancet. 1988 Sep 24;2(8613):742–743. doi: 10.1016/s0140-6736(88)90213-9. [DOI] [PubMed] [Google Scholar]
  3. Centers for Disease Control and Prevention (CDC) Mortality from congestive heart failure--United States, 1980-1990. MMWR Morb Mortal Wkly Rep. 1994 Feb 11;43(5):77–81. [PubMed] [Google Scholar]
  4. Cherian T., John T. J., Simoes E., Steinhoff M. C., John M. Evaluation of simple clinical signs for the diagnosis of acute lower respiratory tract infection. Lancet. 1988 Jul 16;2(8603):125–128. doi: 10.1016/s0140-6736(88)90683-6. [DOI] [PubMed] [Google Scholar]
  5. Gwatkin D. R. How many die? A set of demographic estimates of the annual number of infant and child deaths in the world. Am J Public Health. 1980 Dec;70(12):1286–1289. doi: 10.2105/ajph.70.12.1286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Harari M., Shann F., Spooner V., Meisner S., Carney M., de Campo J. Clinical signs of pneumonia in children. Lancet. 1991 Oct 12;338(8772):928–930. doi: 10.1016/0140-6736(91)91785-s. [DOI] [PubMed] [Google Scholar]
  7. Hortal M., Montano A., Meny M. Simple clinical signs for diagnosis of acute respiratory infections. Lancet. 1989 Nov 25;2(8674):1275–1275. doi: 10.1016/s0140-6736(89)91876-x. [DOI] [PubMed] [Google Scholar]
  8. Leowski J. Mortality from acute respiratory infections in children under 5 years of age: global estimates. World Health Stat Q. 1986;39(2):138–144. [PubMed] [Google Scholar]
  9. Mulholland E. K., Simoes E. A., Costales M. O., McGrath E. J., Manalac E. M., Gove S. Standardized diagnosis of pneumonia in developing countries. Pediatr Infect Dis J. 1992 Feb;11(2):77–81. doi: 10.1097/00006454-199202000-00004. [DOI] [PubMed] [Google Scholar]
  10. Shann F., Hart K., Thomas D. Acute lower respiratory tract infections in children: possible criteria for selection of patients for antibiotic therapy and hospital admission. Bull World Health Organ. 1984;62(5):749–753. [PMC free article] [PubMed] [Google Scholar]
  11. Wall R. A., Corrah P. T., Mabey D. C., Greenwood B. M. The etiology of lobar pneumonia in the Gambia. Bull World Health Organ. 1986;64(4):553–558. [PMC free article] [PubMed] [Google Scholar]

Articles from Bulletin of the World Health Organization are provided here courtesy of World Health Organization

RESOURCES