Table 2.
Examples of varying definitions of severe pneumonia depending on purpose
| Source | Very severe pneumonia | Severe pneumonia | Purpose |
|---|---|---|---|
| WHO [25] | CDB+ multiple convulsions or coma or lethargy or vomiting everything or inability to drink or cyanosis or severe respiratory distress | CDB+ chest indrawing | Treatment of children with suspected pneumonia |
| Cutts et al [34] | Clinically suspected pneumonia with radiological opaque or fluffy opacities in part or all of a lobe of the lung or pleural effusion | Clinical trial of pneumococcal vaccine | |
| Nokes et al [35] | As severe but >2 criteria needed | CDB+ >1 of: intercostal indrawing, inability to feed, increased RR for age, SPO2 <90% | Epidemiological description of admitted cases |
| Scott et al [33] | CDB+ any of: hypoxaemia (SPO2 <90%), inability to feed, head nodding, or impaired consciousness | CDB+ chest indrawing | Epidemiological description of admitted cases |
| Nair et al [23] | As severe, + any IMCI danger sign or hypoxaemia (SPO2 <90%) | CDB+ admitted to hospital | Estimation of global burden |
| Mulholland et al [36] | Invasive Hib disease verified by positive isolate from blood or CSF culture | Randomised clinical trial of Hib vaccine |
CDB+, cough/difficulty breathing plus; IMCI, integrated management of childhood illnesses; SpO2, saturation of peripheral oxygen; RR, respiratory rate; Hib, Haemophilus influenzae type b; CSF, cerebral spinal fluid; WHO, World Health Organization