title: Assessment of clinical criteria for identification of severe acute lower respiratory tract infections in children.
abstract: 222 acute lower respiratory tract infections (LRI), as defined by the World Health Organisation, were identified during one year's surveillance of a cohort of 500 Gambian children aged 0 to 4 years. Symptoms and signs at presentation were related to radiological evidence of lobar consolidation, indicating severe LRI. In infants, a fever of greater than 38.5 degrees C, refusal to breast-feed, or the presence of vomiting were the best predictors of severe LRI. In children aged 1 to 4 years, a fever of greater than 38.5 degrees C or a respiratory rate greater than 60/min were the most accurate clinical signs for severe LRI. Chest indrawing did not discriminate severe LRI. These community-based findings differ from results of hospital-based studies.
authors.affiliation: Medical Research Council Laboratories, Fajara, Banjul, The Gambia.
authors.forename: H
authors.initials: H
authors.lastname: Campbell
authors.forename: P
authors.initials: P
authors.lastname: Byass
authors.forename: A C
authors.initials: AC
authors.lastname: Lamont
authors.forename: I M
authors.initials: IM
authors.lastname: Forgie
authors.forename: K P
authors.initials: KP
authors.lastname: O'Neill
authors.forename: N
authors.initials: N
authors.lastname: Lloyd-Evans
authors.forename: B M
authors.initials: BM
authors.lastname: Greenwood
mesh_terms: D000208:Acute Disease; D001942:Breast Feeding; D002675:Child, Preschool; D003150:Community Health Workers; D005069:Evaluation Studies as Topic; D005334:Fever / Q000209:etiology; D005714:Gambia; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011018:Pneumonia, Pneumococcal / Q000000981:diagnostic imaging; D011859:Radiography; D012119:Respiration; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality; D012424:Rural Population; D012720:Severity of Illness Index; D014839:Vomiting / Q000209:etiology; D014944:World Health Organization