Status: Funded - Open
Sensitivity of lung ultrasound in Ugandan children with radiographic pneumonia
Nathaniel Meuser-Herr, MD
BACKGROUND: Prompt recognition and treatment of pneumonia is crucial, as the case-fatality rate in untreated children is high, often exceeding 20%. However, the complications of integrated management of pneumonia with often co-existing malaria, malnutrition and diarrheal illnesses impact the sensitivity of the diagnostic criteria. Lung ultrasound (L-US) has been shown to be comparable or even more sensitive than CXR in the diagnosis of pediatric pneumonia in multiple studies completed in developed countries.
GAP: No studies of L-US in pediatric pneumonia have been conducted in low-middle income countries where children have risk factors for more severe disease.
HYPOTHESIS: We hypothesize that L-US will perform with at least 80% sensitivity and that with a standardized ultrasound education course and technique, L-US operators will demonstrate almost perfect agreement.
METHODS: A L-US and CXR performed on all children, between the ages of 2-months and 5-years, presenting with a diagnosis of pneumonia by WHO criteria. Operators and radiologists will be blinded to the alternate imaging findings. Interobserver agreement will be tested in comparison of L-US findings between operators who will have received a standardized course in L-US technique and interpretation.
IMPACT: Lung ultrasound has the potential to be come a validated diagnostic study in pediatric pneumonia in the setting of low-middle income countries. It can be taught and implemented in rural areas where CXR is not available. This would build capacity in the diagnosis, referral, and management of severe pneumonia.
Minneapolis Medical Research Foundation
United States, Uganda