Chest radiograph findings in children aged 2-59 months hospitalised with community-acquired pneumonia, prior to the introduction of pneumococcal conjugate vaccine in India: a prospective multisite observational study
The current study was a hospital-based surveillance of cases hospitalised with WHO-defined community-acquired pneumonia in children aged 2-59 months, to assess the radiological abnormalities in chest X-rays and to identify the demographic and clinical correlates of specific radiological abnormalitie...
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| Veröffentlicht in: | BMJ open 2020-05, Vol.10 (5), p.e034066-e034066 |
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| creator | Awasthi, Shally Rastogi, Tuhina Mishra, Neha Chauhan, Abhishek Mohindra, Namita Shukla, Ram Chandra Agarwal, Monika Pandey, Chandra Mani Kohli, Neera Study Group, Cap |
| description | The current study was a hospital-based surveillance of cases hospitalised with WHO-defined community-acquired pneumonia in children aged 2-59 months, to assess the radiological abnormalities in chest X-rays and to identify the demographic and clinical correlates of specific radiological abnormalities, in residents of prespecified districts of Uttar Pradesh and Bihar, India.
Prospective, active, hospital-based surveillance.
Multisite study conducted in a network of 117 secondary/tertiary care hospitals in four districts of Uttar Pradesh and Bihar, India.
Included were children aged 2-59 months, hospitalised with community-acquired pneumonia, residing in the project district, with duration of illness |
| doi_str_mv | 10.1136/bmjopen-2019-034066 |
| format | Article |
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Prospective, active, hospital-based surveillance.
Multisite study conducted in a network of 117 secondary/tertiary care hospitals in four districts of Uttar Pradesh and Bihar, India.
Included were children aged 2-59 months, hospitalised with community-acquired pneumonia, residing in the project district, with duration of illness <14 days and who had not been hospitalised elsewhere for this episode nor had been recruited previously.
Concordant radiological abnormalities in the chest X-rays.
From January 2015 to April 2017, 3214 cases were recruited and in 99.40% (3195/3214) chest X-rays were available, among which 88.54% (2829/3195) were interpretable. Relevant radiological abnormalities were found in 34.53% (977/2829, 95% CI 32.78 to 36.28). These were primary end point pneumonia alone or with other infiltrates in 22.44% (635/2829, 95% CI 20.90% to 23.98%) and other infiltrates in 12.09% (342/2829; 95% CI 10.88% to 13.29%). There was a statistically significant interdistrict variation in radiological abnormalities. Statistically significantly higher proportion of abnormal chest X-rays were found in girls, those with weight-for-age z-score ≤-3SD, longer duration of fever, pallor and with exposure to biomass fuel.
Among hospitalised cases of community-acquired pneumonia, almost one-third children had abnormal chest radiographs, which were higher in females, malnourished children and those with longer illnesses; and an intra-district variation was observed.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2019-034066</identifier><identifier>PMID: 32385059</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adolescent ; Adult ; Caregivers ; Child ; Child mortality ; Child, Preschool ; Children & youth ; Community-Acquired Infections - diagnostic imaging ; Community-Acquired Infections - epidemiology ; Cyanosis ; Etiology ; Female ; Hospitals ; Humans ; India - epidemiology ; Infant ; Male ; Middle Aged ; Observational studies ; Oxygen saturation ; Paediatrics ; Pneumonia ; Pneumonia - diagnostic imaging ; Pneumonia - epidemiology ; Pneumonia, Pneumococcal - diagnostic imaging ; Pneumonia, Pneumococcal - epidemiology ; Pneumonia, Pneumococcal - prevention & control ; Population ; Prospective Studies ; Streptococcus infections ; Surveillance ; Vaccines ; Vaccines, Conjugate ; X-rays ; Young Adult</subject><ispartof>BMJ open, 2020-05, Vol.10 (5), p.e034066-e034066</ispartof><rights>Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.</rights><rights>2020 Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c433t-119fdad9cc9c305bfdbe32a470303716505766d8d6201dcbe759a2cf9ae5391f3</citedby><cites>FETCH-LOGICAL-c433t-119fdad9cc9c305bfdbe32a470303716505766d8d6201dcbe759a2cf9ae5391f3</cites><orcidid>0000-0003-1254-9802</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228527/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228527/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32385059$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Awasthi, Shally</creatorcontrib><creatorcontrib>Rastogi, Tuhina</creatorcontrib><creatorcontrib>Mishra, Neha</creatorcontrib><creatorcontrib>Chauhan, Abhishek</creatorcontrib><creatorcontrib>Mohindra, Namita</creatorcontrib><creatorcontrib>Shukla, Ram Chandra</creatorcontrib><creatorcontrib>Agarwal, Monika</creatorcontrib><creatorcontrib>Pandey, Chandra Mani</creatorcontrib><creatorcontrib>Kohli, Neera</creatorcontrib><creatorcontrib>Study Group, Cap</creatorcontrib><title>Chest radiograph findings in children aged 2-59 months hospitalised with community-acquired pneumonia, prior to the introduction of pneumococcal conjugate vaccine in India: a prospective multisite observational study</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>The current study was a hospital-based surveillance of cases hospitalised with WHO-defined community-acquired pneumonia in children aged 2-59 months, to assess the radiological abnormalities in chest X-rays and to identify the demographic and clinical correlates of specific radiological abnormalities, in residents of prespecified districts of Uttar Pradesh and Bihar, India.
Prospective, active, hospital-based surveillance.
Multisite study conducted in a network of 117 secondary/tertiary care hospitals in four districts of Uttar Pradesh and Bihar, India.
Included were children aged 2-59 months, hospitalised with community-acquired pneumonia, residing in the project district, with duration of illness <14 days and who had not been hospitalised elsewhere for this episode nor had been recruited previously.
Concordant radiological abnormalities in the chest X-rays.
From January 2015 to April 2017, 3214 cases were recruited and in 99.40% (3195/3214) chest X-rays were available, among which 88.54% (2829/3195) were interpretable. Relevant radiological abnormalities were found in 34.53% (977/2829, 95% CI 32.78 to 36.28). These were primary end point pneumonia alone or with other infiltrates in 22.44% (635/2829, 95% CI 20.90% to 23.98%) and other infiltrates in 12.09% (342/2829; 95% CI 10.88% to 13.29%). There was a statistically significant interdistrict variation in radiological abnormalities. Statistically significantly higher proportion of abnormal chest X-rays were found in girls, those with weight-for-age z-score ≤-3SD, longer duration of fever, pallor and with exposure to biomass fuel.
Among hospitalised cases of community-acquired pneumonia, almost one-third children had abnormal chest radiographs, which were higher in females, malnourished children and those with longer illnesses; and an intra-district variation was observed.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Caregivers</subject><subject>Child</subject><subject>Child mortality</subject><subject>Child, Preschool</subject><subject>Children & youth</subject><subject>Community-Acquired Infections - diagnostic imaging</subject><subject>Community-Acquired Infections - epidemiology</subject><subject>Cyanosis</subject><subject>Etiology</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>India - epidemiology</subject><subject>Infant</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Observational studies</subject><subject>Oxygen saturation</subject><subject>Paediatrics</subject><subject>Pneumonia</subject><subject>Pneumonia - diagnostic imaging</subject><subject>Pneumonia - epidemiology</subject><subject>Pneumonia, Pneumococcal - diagnostic imaging</subject><subject>Pneumonia, Pneumococcal - epidemiology</subject><subject>Pneumonia, Pneumococcal - prevention & control</subject><subject>Population</subject><subject>Prospective Studies</subject><subject>Streptococcus infections</subject><subject>Surveillance</subject><subject>Vaccines</subject><subject>Vaccines, Conjugate</subject><subject>X-rays</subject><subject>Young Adult</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpdkk2LFDEQhhtR3GXdXyBIwIsHW9NJJz3tQZDBj4UFL3oO1Ul6OkN30puPkfmn_hxr2HFZzSUh9dSbqspbVS8b-q5puHw_LPuwWl8z2vQ15S2V8kl1yWjb1pIK8fTR-aK6TmlPcbWiF4I9ry444xtBRX9Z_d5ONmUSwbiwi7BOZHTeOL9LxHmiJzebaD2BnTWE1aInS_B5SmQKaXUZZpcw8MvlieiwLMW7fKxB3xUX8X71tiDv4C1ZowuR5EDyZFE5x2CKzi54EsYzp4PWMKOO35cdZEsOoLXzJ5zcYE3wgQDq4MMWMw-WLGXOLjkkw5BsPMBJDxVSLub4ono2wpzs9Xm_qn5--fxj-62-_f71ZvvpttYt57lumn40YHqte82pGEYzWM6g7SinvGskTqmT0myMxEkbPdhO9MD02IMVvG9GflV9vNddy7BYoy32BrPCfheIRxXAqX8j3k1qFw6qY2wjWIcCb84CMdwV_Ay1uKTtPIO3oSTFWkoFl_hliL7-D92HErFlpKRsW7GRvEWK31MaZ5WiHR-Kaag6mUedzaNO5lH35sGsV4_7eMj5axX-B1KTyQI</recordid><startdate>20200507</startdate><enddate>20200507</enddate><creator>Awasthi, Shally</creator><creator>Rastogi, Tuhina</creator><creator>Mishra, Neha</creator><creator>Chauhan, Abhishek</creator><creator>Mohindra, Namita</creator><creator>Shukla, Ram Chandra</creator><creator>Agarwal, Monika</creator><creator>Pandey, Chandra Mani</creator><creator>Kohli, Neera</creator><creator>Study Group, Cap</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1254-9802</orcidid></search><sort><creationdate>20200507</creationdate><title>Chest radiograph findings in children aged 2-59 months hospitalised with community-acquired pneumonia, prior to the introduction of pneumococcal conjugate vaccine in India: a prospective multisite observational study</title><author>Awasthi, Shally ; Rastogi, Tuhina ; Mishra, Neha ; Chauhan, Abhishek ; Mohindra, Namita ; Shukla, Ram Chandra ; Agarwal, Monika ; Pandey, Chandra Mani ; Kohli, Neera ; Study Group, Cap</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c433t-119fdad9cc9c305bfdbe32a470303716505766d8d6201dcbe759a2cf9ae5391f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Caregivers</topic><topic>Child</topic><topic>Child mortality</topic><topic>Child, Preschool</topic><topic>Children & youth</topic><topic>Community-Acquired Infections - diagnostic imaging</topic><topic>Community-Acquired Infections - epidemiology</topic><topic>Cyanosis</topic><topic>Etiology</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>India - epidemiology</topic><topic>Infant</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Observational studies</topic><topic>Oxygen saturation</topic><topic>Paediatrics</topic><topic>Pneumonia</topic><topic>Pneumonia - diagnostic imaging</topic><topic>Pneumonia - epidemiology</topic><topic>Pneumonia, Pneumococcal - diagnostic imaging</topic><topic>Pneumonia, Pneumococcal - epidemiology</topic><topic>Pneumonia, Pneumococcal - prevention & control</topic><topic>Population</topic><topic>Prospective Studies</topic><topic>Streptococcus infections</topic><topic>Surveillance</topic><topic>Vaccines</topic><topic>Vaccines, Conjugate</topic><topic>X-rays</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Awasthi, Shally</creatorcontrib><creatorcontrib>Rastogi, Tuhina</creatorcontrib><creatorcontrib>Mishra, Neha</creatorcontrib><creatorcontrib>Chauhan, Abhishek</creatorcontrib><creatorcontrib>Mohindra, Namita</creatorcontrib><creatorcontrib>Shukla, Ram Chandra</creatorcontrib><creatorcontrib>Agarwal, Monika</creatorcontrib><creatorcontrib>Pandey, Chandra Mani</creatorcontrib><creatorcontrib>Kohli, Neera</creatorcontrib><creatorcontrib>Study Group, Cap</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Awasthi, Shally</au><au>Rastogi, Tuhina</au><au>Mishra, Neha</au><au>Chauhan, Abhishek</au><au>Mohindra, Namita</au><au>Shukla, Ram Chandra</au><au>Agarwal, Monika</au><au>Pandey, Chandra Mani</au><au>Kohli, Neera</au><au>Study Group, Cap</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chest radiograph findings in children aged 2-59 months hospitalised with community-acquired pneumonia, prior to the introduction of pneumococcal conjugate vaccine in India: a prospective multisite observational study</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2020-05-07</date><risdate>2020</risdate><volume>10</volume><issue>5</issue><spage>e034066</spage><epage>e034066</epage><pages>e034066-e034066</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>The current study was a hospital-based surveillance of cases hospitalised with WHO-defined community-acquired pneumonia in children aged 2-59 months, to assess the radiological abnormalities in chest X-rays and to identify the demographic and clinical correlates of specific radiological abnormalities, in residents of prespecified districts of Uttar Pradesh and Bihar, India.
Prospective, active, hospital-based surveillance.
Multisite study conducted in a network of 117 secondary/tertiary care hospitals in four districts of Uttar Pradesh and Bihar, India.
Included were children aged 2-59 months, hospitalised with community-acquired pneumonia, residing in the project district, with duration of illness <14 days and who had not been hospitalised elsewhere for this episode nor had been recruited previously.
Concordant radiological abnormalities in the chest X-rays.
From January 2015 to April 2017, 3214 cases were recruited and in 99.40% (3195/3214) chest X-rays were available, among which 88.54% (2829/3195) were interpretable. Relevant radiological abnormalities were found in 34.53% (977/2829, 95% CI 32.78 to 36.28). These were primary end point pneumonia alone or with other infiltrates in 22.44% (635/2829, 95% CI 20.90% to 23.98%) and other infiltrates in 12.09% (342/2829; 95% CI 10.88% to 13.29%). There was a statistically significant interdistrict variation in radiological abnormalities. Statistically significantly higher proportion of abnormal chest X-rays were found in girls, those with weight-for-age z-score ≤-3SD, longer duration of fever, pallor and with exposure to biomass fuel.
Among hospitalised cases of community-acquired pneumonia, almost one-third children had abnormal chest radiographs, which were higher in females, malnourished children and those with longer illnesses; and an intra-district variation was observed.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>32385059</pmid><doi>10.1136/bmjopen-2019-034066</doi><orcidid>https://orcid.org/0000-0003-1254-9802</orcidid><oa>free_for_read</oa></addata></record> |
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| source | BMJ Open Access Journals; MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adolescent Adult Caregivers Child Child mortality Child, Preschool Children & youth Community-Acquired Infections - diagnostic imaging Community-Acquired Infections - epidemiology Cyanosis Etiology Female Hospitals Humans India - epidemiology Infant Male Middle Aged Observational studies Oxygen saturation Paediatrics Pneumonia Pneumonia - diagnostic imaging Pneumonia - epidemiology Pneumonia, Pneumococcal - diagnostic imaging Pneumonia, Pneumococcal - epidemiology Pneumonia, Pneumococcal - prevention & control Population Prospective Studies Streptococcus infections Surveillance Vaccines Vaccines, Conjugate X-rays Young Adult |
| title | Chest radiograph findings in children aged 2-59 months hospitalised with community-acquired pneumonia, prior to the introduction of pneumococcal conjugate vaccine in India: a prospective multisite observational study |
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