Assessment of clinical criteria for identification of severe acute lower respiratory tract infections in children

Lancet. 1989 Feb 11;1(8633):297-9. doi: 10.1016/s0140-6736(89)91308-1.


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.

MeSH terms

  • Acute Disease
  • Breast Feeding
  • Child, Preschool
  • Community Health Workers
  • Evaluation Studies as Topic
  • Fever / etiology
  • Gambia
  • Humans
  • Infant
  • Infant, Newborn
  • Pneumonia, Pneumococcal / diagnostic imaging
  • Radiography
  • Respiration
  • Respiratory Tract Infections / diagnosis*
  • Respiratory Tract Infections / diagnostic imaging
  • Respiratory Tract Infections / mortality
  • Rural Population
  • Severity of Illness Index*
  • Vomiting / etiology
  • World Health Organization