Objective To describe
chest radiograph findings among
children hospitalized with clinically diagnosed severe
pneumonia and hypoxaemia at three tertiary facilities in
Uganda.
Methods The study involved clinical and radiograph data on a random sample of 375
children aged 28 days to 12 years enrolled in the
Children's
Oxygen Administration Strategies Trial in 2017.
Children were hospitalized with a
history of respiratory illness and respiratory distress complicated by hypoxaemia, defined as a
peripheral oxygen saturation (
SpO2 ) <92%.
Radiologists blinded to clinical findings interpreted
chest radiographs using standardized
World Health Organization method for paediatric
chest radiograph
reporting. We
report clinical and
chest radiograph findings using descriptive
statistics. Findings Overall, 45.9% (172/375) of
children had radiological
pneumonia, 36.3% (136/375) had a normal
chest radiograph and 32.8% (123/375) had other radiograph
abnormalities, with or without
pneumonia. In addition, 28.3% (106/375) had a
cardiovascular abnormality, including 14.9% (56/375) with both
pneumonia and another abnormality. There was no significant difference in the
prevalence of radiological
pneumonia or of
cardiovascular abnormalities or in 28-day
mortality between
children with severe hypoxaemia (
SpO2 <80%) and those with mild hypoxaemia (
SpO2 80 to <92%). Conclusion
Cardiovascular abnormalities were relatively common among
children hospitalized with severe
pneumonia in
Uganda. The standard clinical criteria used to identify
pneumonia among
children in
resource-poor settings were sensitive but lacked
specificity.
Chest radiographs should be performed routinely for all
children with clinical signs of severe
pneumonia because it provides useful information on both cardiovascular and
respiratory systems