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    Digital auscultation in PERCH: Associations with chest radiography and pneumonia mortality in children

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    Author
    McCollum, Eric D.
    Park, Daniel E.
    Watson, Nora L.
    Fancourt, Nicholas S.S.
    Focht, Christopher
    Baggett, Henry C.
    Brooks, W. Abdullah
    Howie, Stephen R.C.
    Kotloff, Karen L.
    Levine, Orin S.
    Madhi, Shabir A.
    Murdoch, David R.
    Scott, J. Anthony G.
    Thea, Donald M.
    Awori, Juliet O.
    Chipeta, James
    Chuananon, Somchai
    DeLuca, Andrea N.
    Driscoll, Amanda J.
    Ebruke, Bernard E.
    Elhilali, Mounya
    Emmanouilidou, Dimitra
    Githua, Louis Peter
    Higdon, Melissa M.
    Hossain, Lokman
    Jahan, Yasmin
    Karron, Ruth A.
    Kyalo, Joshua
    Moore, David P.
    Mulindwa, Justin M.
    Naorat, Sathapana
    Prosperi, Christine
    Verwey, Charl
    West, James E.
    Knoll, Maria Deloria
    O'Brien, Katherine L.
    Feikin, Daniel R.
    Hammitt, Laura L.
    Show allShow less

    Date
    2020-11-01
    Journal
    Pediatric Pulmonology
    Publisher
    Wiley-Blackwell
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1002/ppul.25046
    Abstract
    Background: Whether digitally recorded lung sounds are associated with radiographic pneumonia or clinical outcomes among children in low-income and middle-income countries is unknown. We sought to address these knowledge gaps. Methods: We enrolled 1 to 59 month old children hospitalized with pneumonia at eight African and Asian Pneumonia Etiology Research for Child Health sites in six countries, recorded digital stethoscope lung sounds, obtained chest radiographs, and collected clinical outcomes. Recordings were processed and classified into binary categories positive or negative for adventitial lung sounds. Listening and reading panels classified recordings and radiographs. Recording classification associations with chest radiographs with World Health Organization (WHO)-defined primary endpoint pneumonia (radiographic pneumonia) or mortality were evaluated. We also examined case fatality among risk strata. Results: Among children without WHO danger signs, wheezing (without crackles) had a lower adjusted odds ratio (aOR) for radiographic pneumonia (0.35, 95% confidence interval (CI): 0.15, 0.82), compared to children with normal recordings. Neither crackle only (no wheeze) (aOR: 2.13, 95% CI: 0.91, 4.96) or any wheeze (with or without crackle) (aOR: 0.63, 95% CI: 0.34, 1.15) were associated with radiographic pneumonia. Among children with WHO danger signs no lung recording classification was independently associated with radiographic pneumonia, although trends toward greater odds of radiographic pneumonia were observed among children classified with crackle only (no wheeze) or any wheeze (with or without crackle). Among children without WHO danger signs, those with recorded wheezing had a lower case fatality than those without wheezing (3.8% vs. 9.1%, p =.03). Conclusions: Among lower risk children without WHO danger signs digitally recorded wheezing is associated with a lower odds for radiographic pneumonia and with lower mortality. Although further research is needed, these data indicate that with further development digital auscultation may eventually contribute to child pneumonia care.
    Sponsors
    Bill and Melinda Gates Foundation
    Keyword
    child
    developing countries
    digital auscultation
    radiography
    respiratory tract infections
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/13875
    ae974a485f413a2113503eed53cd6c53
    10.1002/ppul.25046
    Scopus Count
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    UMB Open Access Articles 2020

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