A new study published in BMJ Open assessed the radiological abnormalities in chest X-rays and identified demographic and clinical correlates of specific radiological abnormalities, in residents of prespecified districts of Uttar Pradesh and Bihar, India.

This was a prospective, active, hospital-based surveillance of cases hospitalized with WHO-defined community-acquired pneumonia, conducted among children aged 2-59 months. The study was carried out in a network of 117 secondary/tertiary care hospitals in four districts of Uttar Pradesh and Bihar, India. Children with a duration of illness < 14 days were selected, who had not been hospitalized elsewhere for this episode nor had been recruited previously.

Overall, 3 214 cases were recruited and in 99.40% chest X-rays were available from 2015-17, among which 88.54% were interpretable. Primary end points were pneumonia alone or with other infiltrates in 22.44% and other infiltrates in 12.09%. The results revealed a statistically significant interdistrict variation in radiological abnormalities. Statistically significantly higher proportion of abnormal chest X-rays were found in girls—those with weight-for-age z-score ≤-3SD, longer duration of fever, pallor and with exposure to biomass fuel.

It was inferred that among hospitalized cases of community-acquired pneumonia, almost one-third children had abnormal chest radiographs—which were higher in females, malnourished children and those with longer illnesses. Furthermore, an intra-district variation was noted.

Source: BMJ Open. 2020 May 7;10(5):e034066. doi: 10.1136/bmjopen-2019-034066.