Validity of clinical signs for the identification of pneumonia in children

Ann Trop Paediatr. 1994;14(1):53-8. doi: 10.1080/02724936.1994.11747692.


In a prospective study to determine simplified clinical signs predictive of pneumonia in children between 2 months and 5 years of age, and to test the validity of the signs recommended by the World Health Organization, clinical findings were correlated with X-ray evidence of pneumonia in 854 children, 400 with pneumonia and 454 with upper respiratory infections (no pneumonia). A respiratory rate of > or = 50/min in infants 2-6 months of age, > or = 40/min in children 7-35 months, and > or = 35/min in children > or = 36 months was the best discriminator of radiological evidence of pneumonia. Use of a respiratory rate of > or = 50/min instead of > or = 40/min resulted in a 14%, 19% and 32% loss of sensitivity with little gain in specificity in the age groups 7-11 months, 12-35 months and > or = 36 months, respectively. The age-specific respiratory rate (recommended by WHO) and/or chest indrawing, history of rapid or difficult breathing and/or chest indrawing, and nasal flaring were also sensitive and specific indicators of pneumonia in almost all the age groups studied.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Child, Preschool
  • Female
  • Humans
  • India
  • Infant
  • Male
  • Pneumonia / complications
  • Pneumonia / diagnosis*
  • Pneumonia / diagnostic imaging
  • Prospective Studies
  • Radiography
  • Respiration*
  • Sensitivity and Specificity
  • World Health Organization