Abstract
Lung ultrasound (LUS) is a promising point-of-care imaging technology for diagnosing and managing pneumonia. We sought to explore serial LUS examinations in children with chest-indrawing pneumonia in resource-constrained settings and compare their clinical and LUS imaging courses longitudinally. We conducted a prospective, observational study among children aged 2 through 23 months with World Health Organization Integrated Management of Childhood Illness chest-indrawing pneumonia and among children without fast breathing, chest indrawing or fever (no pneumonia cohort) at 2 district hospitals in Mozambique and Pakistan. We assessed serial LUS at enrollment, 2, 6, and 14 days, and performed a secondary analysis of enrolled children’s longitudinal clinical and imaging courses. By Day 14, the majority of children with chest-indrawing pneumonia and consolidation on enrollment LUS showed improvement on follow-up LUS (100% in Mozambique, 85.4% in Pakistan) and were clinically cured (100% in Mozambique, 78.0% in Pakistan). In our cohort of children with chest-indrawing pneumonia, LUS imaging often reflected the clinical course; however, it is unclear how serial LUS would inform the routine management of non-severe chest-indrawing pneumonia.
Highlights
Lung ultrasound (LUS) is a promising point-of-care imaging technology for diagnosing and managing pneumonia
We conducted a pilot study in Mozambique and Pakistan to investigate the use of LUS for diagnosis among children with World Health Organization (WHO) Integrated Management of Childhood Illness (IMCI) chest-indrawing pneumonia and found that expert LUS interpreters may achieve substantially higher interrater reliability (IRR) for LUS compared to C XR6
We explore serial LUS examinations in children with chest-indrawing pneumonia and compare their clinical and imaging courses longitudinally
Summary
Lung ultrasound (LUS) is a promising point-of-care imaging technology for diagnosing and managing pneumonia. The remaining 37 available LUS and clinical data for children in the no pneumonia cohort in Mozambique and Pakistan had normal enrollment and follow-up LUS examinations.
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