Clinical predictors of radiological pneumonia: A cross-sectional study from a tertiary hospital in Nepal
Background Despite readily availability of vaccines against both Hemophilus influenzae and Pneumococcus, pneumonia remains the most common cause of morbidity and mortality in children under the age of five years in Nepal. With growing antibiotic resistance and a general move towards more rational an...
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| Vydané v: | PloS one Ročník 15; číslo 7; s. e0235598 |
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| Hlavní autori: | , , , , , , |
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| Jazyk: | English |
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| Abstract | Background Despite readily availability of vaccines against both Hemophilus influenzae and Pneumococcus, pneumonia remains the most common cause of morbidity and mortality in children under the age of five years in Nepal. With growing antibiotic resistance and a general move towards more rational antibiotic use, early identification of clinical signs for the prediction of radiological pneumonia would help practitioners to start the treatment of patients. The main aim of this study was to reassess the clinical predictors of pneumonia in Nepal. Methods This cross-sectional study was conducted between June 2015 and November 2015 at Tribhuvan University Teaching Hospital, a tertiary hospital in Kathmandu, Nepal. Children aged 3–60 months with a clinical diagnosis of pneumonia by a physician were enrolled in the study. Radiological pneumonia was identified and categorized as per World Health Organization guidelines by an experienced radiologist blinded to patient characteristics. We calculated sensitivity and specificity of clinical signs and symptoms for radiological pneumonia. Results Out of 1021 children with fever, 160 cases were clinically diagnosed as pneumonia and were enrolled for this study. Among the enrolled patients, 61% had radiological pneumonia. Tachypnea had the highest sensitivity of 99%, while bronchial breathing had the highest specificity of 100%. During univariate analysis, grunting, wheezing, nasal discharge, decreased breath sounds, noisy breathing and hypoxemia were associated with radiological pneumonia. Only hypoxemia remained an independent predictor when adjusted for all the factors. Conclusion Tachypnea was the most sensitive sign, whereas bronchial breathing was most specific sign for radiological pneumonia. |
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| AbstractList | Despite readily availability of vaccines against both Hemophilus influenzae and Pneumococcus, pneumonia remains the most common cause of morbidity and mortality in children under the age of five years in Nepal. With growing antibiotic resistance and a general move towards more rational antibiotic use, early identification of clinical signs for the prediction of radiological pneumonia would help practitioners to start the treatment of patients. The main aim of this study was to reassess the clinical predictors of pneumonia in Nepal.BACKGROUNDDespite readily availability of vaccines against both Hemophilus influenzae and Pneumococcus, pneumonia remains the most common cause of morbidity and mortality in children under the age of five years in Nepal. With growing antibiotic resistance and a general move towards more rational antibiotic use, early identification of clinical signs for the prediction of radiological pneumonia would help practitioners to start the treatment of patients. The main aim of this study was to reassess the clinical predictors of pneumonia in Nepal.This cross-sectional study was conducted between June 2015 and November 2015 at Tribhuvan University Teaching Hospital, a tertiary hospital in Kathmandu, Nepal. Children aged 3-60 months with a clinical diagnosis of pneumonia by a physician were enrolled in the study. Radiological pneumonia was identified and categorized as per World Health Organization guidelines by an experienced radiologist blinded to patient characteristics. We calculated sensitivity and specificity of clinical signs and symptoms for radiological pneumonia.METHODSThis cross-sectional study was conducted between June 2015 and November 2015 at Tribhuvan University Teaching Hospital, a tertiary hospital in Kathmandu, Nepal. Children aged 3-60 months with a clinical diagnosis of pneumonia by a physician were enrolled in the study. Radiological pneumonia was identified and categorized as per World Health Organization guidelines by an experienced radiologist blinded to patient characteristics. We calculated sensitivity and specificity of clinical signs and symptoms for radiological pneumonia.Out of 1021 children with fever, 160 cases were clinically diagnosed as pneumonia and were enrolled for this study. Among the enrolled patients, 61% had radiological pneumonia. Tachypnea had the highest sensitivity of 99%, while bronchial breathing had the highest specificity of 100%. During univariate analysis, grunting, wheezing, nasal discharge, decreased breath sounds, noisy breathing and hypoxemia were associated with radiological pneumonia. Only hypoxemia remained an independent predictor when adjusted for all the factors.RESULTSOut of 1021 children with fever, 160 cases were clinically diagnosed as pneumonia and were enrolled for this study. Among the enrolled patients, 61% had radiological pneumonia. Tachypnea had the highest sensitivity of 99%, while bronchial breathing had the highest specificity of 100%. During univariate analysis, grunting, wheezing, nasal discharge, decreased breath sounds, noisy breathing and hypoxemia were associated with radiological pneumonia. Only hypoxemia remained an independent predictor when adjusted for all the factors.Tachypnea was the most sensitive sign, whereas bronchial breathing was most specific sign for radiological pneumonia.CONCLUSIONTachypnea was the most sensitive sign, whereas bronchial breathing was most specific sign for radiological pneumonia. Background Despite readily availability of vaccines against both Hemophilus influenzae and Pneumococcus, pneumonia remains the most common cause of morbidity and mortality in children under the age of five years in Nepal. With growing antibiotic resistance and a general move towards more rational antibiotic use, early identification of clinical signs for the prediction of radiological pneumonia would help practitioners to start the treatment of patients. The main aim of this study was to reassess the clinical predictors of pneumonia in Nepal. Methods This cross-sectional study was conducted between June 2015 and November 2015 at Tribhuvan University Teaching Hospital, a tertiary hospital in Kathmandu, Nepal. Children aged 3–60 months with a clinical diagnosis of pneumonia by a physician were enrolled in the study. Radiological pneumonia was identified and categorized as per World Health Organization guidelines by an experienced radiologist blinded to patient characteristics. We calculated sensitivity and specificity of clinical signs and symptoms for radiological pneumonia. Results Out of 1021 children with fever, 160 cases were clinically diagnosed as pneumonia and were enrolled for this study. Among the enrolled patients, 61% had radiological pneumonia. Tachypnea had the highest sensitivity of 99%, while bronchial breathing had the highest specificity of 100%. During univariate analysis, grunting, wheezing, nasal discharge, decreased breath sounds, noisy breathing and hypoxemia were associated with radiological pneumonia. Only hypoxemia remained an independent predictor when adjusted for all the factors. Conclusion Tachypnea was the most sensitive sign, whereas bronchial breathing was most specific sign for radiological pneumonia. Background Despite readily availability of vaccines against both Hemophilus influenzae and Pneumococcus, pneumonia remains the most common cause of morbidity and mortality in children under the age of five years in Nepal. With growing antibiotic resistance and a general move towards more rational antibiotic use, early identification of clinical signs for the prediction of radiological pneumonia would help practitioners to start the treatment of patients. The main aim of this study was to reassess the clinical predictors of pneumonia in Nepal. Methods This cross-sectional study was conducted between June 2015 and November 2015 at Tribhuvan University Teaching Hospital, a tertiary hospital in Kathmandu, Nepal. Children aged 3–60 months with a clinical diagnosis of pneumonia by a physician were enrolled in the study. Radiological pneumonia was identified and categorized as per World Health Organization guidelines by an experienced radiologist blinded to patient characteristics. We calculated sensitivity and specificity of clinical signs and symptoms for radiological pneumonia. Results Out of 1021 children with fever, 160 cases were clinically diagnosed as pneumonia and were enrolled for this study. Among the enrolled patients, 61% had radiological pneumonia. Tachypnea had the highest sensitivity of 99%, while bronchial breathing had the highest specificity of 100%. During univariate analysis, grunting, wheezing, nasal discharge, decreased breath sounds, noisy breathing and hypoxemia were associated with radiological pneumonia. Only hypoxemia remained an independent predictor when adjusted for all the factors. Conclusion Tachypnea was the most sensitive sign, whereas bronchial breathing was most specific sign for radiological pneumonia. BackgroundDespite readily availability of vaccines against both Hemophilus influenzae and Pneumococcus, pneumonia remains the most common cause of morbidity and mortality in children under the age of five years in Nepal. With growing antibiotic resistance and a general move towards more rational antibiotic use, early identification of clinical signs for the prediction of radiological pneumonia would help practitioners to start the treatment of patients. The main aim of this study was to reassess the clinical predictors of pneumonia in Nepal.MethodsThis cross-sectional study was conducted between June 2015 and November 2015 at Tribhuvan University Teaching Hospital, a tertiary hospital in Kathmandu, Nepal. Children aged 3-60 months with a clinical diagnosis of pneumonia by a physician were enrolled in the study. Radiological pneumonia was identified and categorized as per World Health Organization guidelines by an experienced radiologist blinded to patient characteristics. We calculated sensitivity and specificity of clinical signs and symptoms for radiological pneumonia.ResultsOut of 1021 children with fever, 160 cases were clinically diagnosed as pneumonia and were enrolled for this study. Among the enrolled patients, 61% had radiological pneumonia. Tachypnea had the highest sensitivity of 99%, while bronchial breathing had the highest specificity of 100%. During univariate analysis, grunting, wheezing, nasal discharge, decreased breath sounds, noisy breathing and hypoxemia were associated with radiological pneumonia. Only hypoxemia remained an independent predictor when adjusted for all the factors.ConclusionTachypnea was the most sensitive sign, whereas bronchial breathing was most specific sign for radiological pneumonia. |
| Author | Chaudhary, Nagendra Kurmi, Om P. Shrestha, Sandeep Pathak, Santosh Sharma, Arun Shrestha, Saneep Shrestha, Laxman |
| AuthorAffiliation | 2 Department of Community Medicine, Universal College of Medical Sciences, Bhairahawa, Nepal 5 Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada The University of Georgia, UNITED STATES 1 Department of Pediatrics, Universal College of Medical Sciences, Bhairahawa, Nepal 3 Department of Pediatrics, Chitwan Medical College, Bharatpur, Nepal 4 Department of Pediatrics, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal |
| AuthorAffiliation_xml | – name: 5 Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada – name: 2 Department of Community Medicine, Universal College of Medical Sciences, Bhairahawa, Nepal – name: 4 Department of Pediatrics, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal – name: 3 Department of Pediatrics, Chitwan Medical College, Bharatpur, Nepal – name: 1 Department of Pediatrics, Universal College of Medical Sciences, Bhairahawa, Nepal – name: The University of Georgia, UNITED STATES |
| Author_xml | – sequence: 1 givenname: Sandeep orcidid: 0000-0002-0365-3299 surname: Shrestha fullname: Shrestha, Sandeep – sequence: 2 givenname: Nagendra orcidid: 0000-0002-3216-8671 surname: Chaudhary fullname: Chaudhary, Nagendra – sequence: 3 givenname: Saneep surname: Shrestha fullname: Shrestha, Saneep – sequence: 4 givenname: Santosh surname: Pathak fullname: Pathak, Santosh – sequence: 5 givenname: Arun surname: Sharma fullname: Sharma, Arun – sequence: 6 givenname: Laxman surname: Shrestha fullname: Shrestha, Laxman – sequence: 7 givenname: Om P. surname: Kurmi fullname: Kurmi, Om P. |
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| Copyright | 2020 Shrestha et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2020 Shrestha et al 2020 Shrestha et al |
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| Snippet | Background Despite readily availability of vaccines against both Hemophilus influenzae and Pneumococcus, pneumonia remains the most common cause of morbidity... Despite readily availability of vaccines against both Hemophilus influenzae and Pneumococcus, pneumonia remains the most common cause of morbidity and... BackgroundDespite readily availability of vaccines against both Hemophilus influenzae and Pneumococcus, pneumonia remains the most common cause of morbidity... Background Despite readily availability of vaccines against both Hemophilus influenzae and Pneumococcus, pneumonia remains the most common cause of morbidity... |
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| SubjectTerms | Acoustics Antibiotic resistance Antibiotics Asthma Biology and Life Sciences Children Children & youth Cross-sectional studies Drug resistance Fever Hypoxemia Medical diagnosis Medicine Medicine and Health Sciences Morbidity Oxygen saturation Patients Pediatrics People and Places Pneumonia Regression analysis Sensitivity Signs and symptoms Software Streptococcus infections Tachypnea Teaching hospitals Vaccines Variables Wheezing X rays |
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| Title | Clinical predictors of radiological pneumonia: A cross-sectional study from a tertiary hospital in Nepal |
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