Misdiagnosis of pneumonia, bronchiolitis and reactive airway disease in children: A retrospective case review series in South East, Nigeria.

Background: Pneumonia is a major cause of morbidity and mortality in children especially in sub Saharan Africa and Asia. Recent studies suggest that pneumonia may be overdiagnosed at the expense of other acute respiratory conditions with similar features such as asthma and other wheezy conditions, and bronchiolitis. This study examined the prevalence and diagnostic concordance of hospital diagnoses made with an established Case Definition Criteria (CDC) for these three common respiratory disorders in the south east region of Nigeria Materials and Methods: Hospital admission records of all children aged between 2 and 59 months who presented with, catarrh, respiratory distress, cough and fever between January and December 2015 in the children emergency room of three hospitals in South East Nigeria were reviewed. Results: A total of 186 case records met the inclusion criteria and were analyzed. Bronchopneumonia accounted for 41.9%, of the cases admitted; while reactive airway disease and bronchiolitis accounted for 16.1% and 9.1% respectively based on the hospital diagnoses, and 33.3%, 23.1% and 5.9% respectively using the case definition criteria. The positive and negative predictive values for diagnosing bronchopneumonia (BP) were 72% and of 94% respectively. For reactive airway disease (RAD), the values were 57% and 83% respectively while that for bronchiolitis (BL) were 53% and 99% respectively. Conclusion: There is need for a review of the criteria for diagnosis of these respiratory conditions in children that are similar to forestall the danger of misdiagnosis and inappropriate treatment of children with these conditions