OBJECTIVE: To examine the ability of the criteria proposed by the WHO to identify pneumonia among cases presenting with wheezing and the extent to which adding fever to the criteria alters their performance. DESIGN: Prospective classification of 390 children aged 2-59 months with lower respiratory tract disease into five diagnostic categories, including pneumonia. WHO criteria for the identification of pneumonia and a set of such criteria modified by adding fever were compared with radiographically diagnosed pneumonia as the gold standard. RESULTS: The sensitivity of the WHO criteria was 94% for children aged <24 months and 62% for those aged ≥24 months. The corresponding specificities were 20% and 16%. Adding fever to the WHO criteria improved specificity substantially (to 44% and 50%, respectively). The specificity of the WHO criteria was poor for children with wheezing (12%). Adding fever improved this substantially (to 42%). The addition of fever to the criteria apparently reduced their sensitivity only marginally (to 92% and 57%, respectively, in the two age groups). CONCLUSION: The authors' results reaffirm that the current WHO criteria can detect pneumonia with high sensitivity, particularly among younger children. They present evidence that the ability of these criteria to distinguish between children with pneumonia and those with wheezing diseases might be greatly enhanced by the addition of fever.
OBJECTIVE: To examine the ability of the criteria proposed by the WHO to identify pneumonia among cases presenting with wheezing and the extent to which adding fever to the criteria alters their performance. DESIGN: Prospective classification of 390 children aged 2-59 months with lower respiratory tract disease into five diagnostic categories, including pneumonia. WHO criteria for the identification of pneumonia and a set of such criteria modified by adding fever were compared with radiographically diagnosed pneumonia as the gold standard. RESULTS: The sensitivity of the WHO criteria was 94% for children aged <24 months and 62% for those aged ≥24 months. The corresponding specificities were 20% and 16%. Adding fever to the WHO criteria improved specificity substantially (to 44% and 50%, respectively). The specificity of the WHO criteria was poor for children with wheezing (12%). Adding fever improved this substantially (to 42%). The addition of fever to the criteria apparently reduced their sensitivity only marginally (to 92% and 57%, respectively, in the two age groups). CONCLUSION: The authors' results reaffirm that the current WHO criteria can detect pneumonia with high sensitivity, particularly among younger children. They present evidence that the ability of these criteria to distinguish between children with pneumonia and those with wheezing diseases might be greatly enhanced by the addition of fever.
Authors: Emmanuel Addo-Yobo; Dang D Anh; Hesham F El-Sayed; LeAnne M Fox; Matthew P Fox; William MacLeod; Samir Saha; Tran A Tuan; Donald M Thea; Shamim Qazi Journal: Trop Med Int Health Date: 2011-05-04 Impact factor: 2.622
Authors: Miguel A Chavez; Neha Naithani; Robert H Gilman; James M Tielsch; Subarna Khatry; Laura E Ellington; J Jaime Miranda; Ghanashyam Gurung; Shalim Rodriguez; William Checkley Journal: Lung Date: 2015-04-29 Impact factor: 2.584
Authors: Laura E Ellington; Robert H Gilman; James M Tielsch; Mark Steinhoff; Dante Figueroa; Shalim Rodriguez; Brian Caffo; Brian Tracey; Mounya Elhilali; James West; William Checkley Journal: BMJ Open Date: 2012-02-03 Impact factor: 2.692
Authors: Tabish Hazir; Khadija Begum; Shams El Arifeen; Amira M Khan; M Hamidul Huque; Narjis Kazmi; Sushmita Roy; Saleem Abbasi; Qazi Sadeq-Ur Rahman; Evropi Theodoratou; Mahmuda Shayema Khorshed; Kazi Mizanur Rahman; Sanwarul Bari; M Mahfuzul Islam Kaiser; Samir K Saha; A S M Nawshad Uddin Ahmed; Igor Rudan; Jennifer Bryce; Shamim Ahmad Qazi; Harry Campbell Journal: PLoS Med Date: 2013-05-07 Impact factor: 11.069