Diagnosis of acute respiratory infections (ARI) among under fives in the paediatric observation ward (POW) , Kenyatta National Hospital, Nairobi
Wafula, E.M.; Tukei, P.M.; Bell, T.M.; Nzanze, H.; Ndinya-Achola, J.O.; Hazlett, D.T.; Ademba, G.R.; Pamba, A.
East African Medical Journal 64(4): 263-269
1987
ISSN/ISBN: 0012-835X PMID: 3691346 Document Number: 297672
Classification of acute respiratory infections into their respective clinical syndromes, like pneumonia or bronchiolitis, is dependent on the clinical history and signs and the results of investigations like a chest X-ray. Although chest X-ray is acceptable as a confirmatory investigation for pneumonia, the reliability of other parameters like history and clinical signs have often been taken for granted. In a study of 782 children admitted in Kenyatta National Hospital emergency paediatric ward in 1981/1982, heart rate, fever, reduced air entry, fine crepitations, and bronchial breathing were not found to be specific for children diagnosed as having pneumonia. Flaring alae, nasae, chest retraction, and coarse crepitations were frequently found in children with pneumonia while wheezing and rhonchi were more frequent in children with bronchiolitis and asthma. Hoarseness and stridor was more frequent in croup (TLB). Twenty-nine per cent of pneumonia patients had normal X-rays while 50%, 60%, and 40% of the children respectively with upper respiratory infection, bronchiolitis, bronchial asthma, and croup had pneumonia. Eight per cent of the patients had more than one diagnosis.