RESPIRATORY RATE AND SIGNS IN ROENTGENOGRAPHICALLY CONFIRMED PNEUMONIA AMONG CHILDREN IN CHINA

A clinical study was conducted in three Chinese community hospitals to investigate the reliability of respiratory rate and various clinical signs in the diagnosis of pneumonia among 54 children less than 5 year s of age. Anteroposterior chest film was used as the diagnostic standa rd. The cutoff criterion for rapid breathing was 50 breaths/minute for infants ages 2 to 11 months and 40/minute in children 1 to 5 years ol d. Rapid breathing was a better predictor of pneumonia than rales (pos itive predictive values of 74.5 and 66.9%). Nasal flaring, chest indra wing, strider and cyanosis of the tongue had predictive values of > 86 %, but these clinical signs were observed in only a small proportion o f patients. We recommend that village health workers use rapid breathi ng for diagnosis of pneumonia, rather than auscultation which is diffi cult and has proved unreliable. Sensitivity, specificity and positive and negative predictive values are presented for seven signs and sympt oms of pneumonia.