%0 Journal Article
%T Chest radiograph findings in children aged 2¨C59 months hospitalised with community-acquired pneumonia, prior to the introduction of pneumococcal conjugate vaccine in India: a prospective multisite observational study
%A Abhishek Chauhan
%A CAP Study Group
%A Chandra Mani Pandey
%A Monika Agarwal
%A Namita Mohindra
%A Neera Kohli
%A Neha Mishra
%A Ram Chandra Shukla
%A Shally Awasthi
%A Tuhina Rastogi
%J -
%D 2020
%R 10.1136/bmjopen-2019-034066
%X Objectives The current study was a hospital-based surveillance of cases hospitalised with WHO-defined community-acquired pneumonia in children aged 2¨C59 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.

Design Prospective, active, hospital-based surveillance.

Setting Multisite study conducted in a network of 117 secondary/tertiary care hospitals in four districts of Uttar Pradesh and Bihar, India.

Participants Included were children aged 2¨C59 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.

Main outcome measure Concordant radiological abnormalities in the chest X-rays.

Results 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 ¡Ü£¿3SD, longer duration of fever, pallor and with exposure to biomass fuel.

Conclusions 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
%U https://bmjopen.bmj.com/content/10/5/e034066