Digital auscultation in PERCH: Associations with chest radiography and pneumonia mortality in children
Year: 2020
Type: article
Study design: Observational Study
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 59monthold 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.
Source: Pediatric Pulmonology
DOI: 10.1002/ppul.25046
Authors: Eric D. McCollum, Daniel E. Park, Nora L. Watson, Nicholas S. S. Fancourt, Christopher Focht, Henry C. Baggett, W. Abdullah Brooks, Stephen R. C. Howie, Karen L. Kotloff, Orin S. Levine, Shabir A. Madhi, David R. Murdoch, J. Anthony G. Scott, Donald M. Thea, Juliet O. Awori, James Chipeta, Somchai Chuananon, Andrea N. DeLuca, Amanda J. Driscoll, Bernard E. Ebruke, Mounya Elhilali, Dimitra Emmanouilidou, Louis Peter Githua, Melissa M. Higdon, Lokman Hossain, Yasmin Jahan, Ruth A. Karron, Joshua Kyalo, David P. Moore, Justin M. Mulindwa, Sathapana Naorat, Christine Prosperi, Charl Verwey, James E. West, Maria Deloria Knoll, Katherine L. O'Brien, Daniel R. Feikin, Laura L. Hammitt
Institutions: Johns Hopkins University, Johns Hopkins Medicine, George Washington University, Emmes (United States), Centers for Disease Control and Prevention, Ministry of Public Health, Center for Global Health, International Centre for Diarrhoeal Disease Research, University of Auckland, MRC Unit the Gambia, University of Otago, Medical Research Council, University of Maryland, Baltimore, Gates Foundation, University of the Witwatersrand, Respiratory and Meningeal Pathogens Research Unit, National Research Foundation, Canterbury Health Laboratories, Kenya Medical Research Institute, London School of Hygiene & Tropical Medicine, KEMRI-Wellcome Trust Research Programme, Wellcome Trust, Boston University, University Teaching Hospital, International Foundation Against Infectious Disease in Nigeria
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,822
Awards: Johns Hopkins University - to conduct a digital auscultation study of pneumonia etiology research for child health, Johns Hopkins University - to support the Pneumonia Etiology Research for Child Health (PERCH) Project, Pulse oximetry for childhood pneumonia in rural Bangladesh, Population impact of conjugate vaccine on pneumococcal transmission and disease in Kenya., Multidisciplinary Training Program in Pediatric Pulmonary
OpenAlex ID: W3080731188