Clinical Predictors of Pneumonia Among Under-five Children At Tikur Anbesa Specilaized Hospital

Abstract

The aim of the study is to identify simple clinical signs and symptoms in under five children which are predictors of pneumonia at Tikur Anbesa Specialized Hospital (TASH), Department of Pediatrics and Child Health, emergency and regular out-patient units. The design of the study is a prospective crosssectional study carried out during Aug 2004 – Sep 2005. All children between the age of 2-59 months who
attended the regular and emergency pediatrics units at TASH during the study period who had either cough or difficulty of breathing or chest x-ray evidence of pneumonia were included in the study. A calculated sample of 164 was taken. Data analysis was done using SPSS and EPINFO version 1.1.2. Chi-square test was used to calculate the differences in distribution of clinical signs and symptoms between groups with and without chest x-ray (CXR) evidence of pneumonia. A total of 179 patients were studied of whom 102 were males and 77 females (M:F 1:0.75). Clinical symptoms and signs were related to CXR pneumonia. Tachypnea (94.5% with CXR pneumonia Vs 59.3% without CXR pneumonia) and retraction (86.3% CXR Vs 40.6% without CXR pneumonia) were the best clinical predictors of pneumonia. Tachypnea, flaring of alae nasi and retraction were also independently associated with CXR pneumonia. Vomiting, refusal to feed, history of rapid breathing , grunting and chest findings did not predict pneumonia. In conclusion pneumonia is a significant cause of morbidity and mortality in developing countries like Ethiopia . Using simple clinical indicators pneumonia can be diagnosed by primary health workers and mortality can be reduced significantly.