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dc.contributor.authorMcCollum, Eric D.
dc.contributor.authorPark, Daniel E.
dc.contributor.authorWatson, Nora L.
dc.contributor.authorFancourt, Nicholas S.S.
dc.contributor.authorFocht, Christopher
dc.contributor.authorBaggett, Henry C.
dc.contributor.authorBrooks, W. Abdullah
dc.contributor.authorHowie, Stephen R.C.
dc.contributor.authorKotloff, Karen L.
dc.contributor.authorLevine, Orin S.
dc.contributor.authorMadhi, Shabir A.
dc.contributor.authorMurdoch, David R.
dc.contributor.authorScott, J. Anthony G.
dc.contributor.authorThea, Donald M.
dc.contributor.authorAwori, Juliet O.
dc.contributor.authorChipeta, James
dc.contributor.authorChuananon, Somchai
dc.contributor.authorDeLuca, Andrea N.
dc.contributor.authorDriscoll, Amanda J.
dc.contributor.authorEbruke, Bernard E.
dc.contributor.authorElhilali, Mounya
dc.contributor.authorEmmanouilidou, Dimitra
dc.contributor.authorGithua, Louis Peter
dc.contributor.authorHigdon, Melissa M.
dc.contributor.authorHossain, Lokman
dc.contributor.authorJahan, Yasmin
dc.contributor.authorKarron, Ruth A.
dc.contributor.authorKyalo, Joshua
dc.contributor.authorMoore, David P.
dc.contributor.authorMulindwa, Justin M.
dc.contributor.authorNaorat, Sathapana
dc.contributor.authorProsperi, Christine
dc.contributor.authorVerwey, Charl
dc.contributor.authorWest, James E.
dc.contributor.authorKnoll, Maria Deloria
dc.contributor.authorO'Brien, Katherine L.
dc.contributor.authorFeikin, Daniel R.
dc.contributor.authorHammitt, Laura L.
dc.date.accessioned2020-10-16T16:43:28Z
dc.date.available2020-10-16T16:43:28Z
dc.date.issued2020-11-01
dc.identifier.urihttp://hdl.handle.net/10713/13875
dc.description.abstractBackground: 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.en_US
dc.description.sponsorshipBill and Melinda Gates Foundationen_US
dc.description.urihttps://doi.org/10.1002/ppul.25046en_US
dc.language.isoenen_US
dc.publisherWiley-Blackwellen_US
dc.relation.ispartofPediatric Pulmonologyen_US
dc.subjectchilden_US
dc.subjectdeveloping countriesen_US
dc.subjectdigital auscultationen_US
dc.subjectradiographyen_US
dc.subjectrespiratory tract infectionsen_US
dc.titleDigital auscultation in PERCH: Associations with chest radiography and pneumonia mortality in childrenen_US
dc.typeArticleen_US
dc.identifier.doi10.1002/ppul.25046
dc.identifier.pmid32852888
dc.source.volume55
dc.source.issue11
dc.source.beginpage3197
dc.source.endpage3208


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