Predictive Value of Respiratory Rate Thresholds in Pneumonia among Preschool Children in Enugu, Nigeria

Abstract

Summary: A study was carried out to determine the predictive value of respiratory rate in the clinical diagnosis of pneumonia in 101 children with respiratory symptoms of <28 days duration. Clinical, demographic and anthropometric variables were obtained at presentation while confirmation of the diagnosis was by a chest x-ray in each subject. Fifty-two of the subjects had radiological pneumonia; 42(80 percent) of them were less than three years old including 22 (42 percent) less than one year. The male to female ratio was 1.3:1. Of the 52 children with pneumonia, 38 (73 percent) had respiratory rate >50/minute, while 43 (83 percent) had respiratory rate >40/min. When all age groups are considered, subjects with pneumonia had significantly higher respiratory rates. Respiratory rate was found to be least reliable as an indicator of pneumonia in children aged 2-11 months in whom the widest variation of respiratory rate was identified. For children aged 12-35 months, a respiratory rate of >50/min was a good predictor of pneumonia while a respiratory rate of 235/min was highly sensitive in children 236 months old. The current data suggest that the age specific respiratory rate cut off recommended by WHO programme for the control of acute respiratory infections need to be reviewed.

Keywords: Predictive value, Respiratory rate, Pneumonia, Pre-school