Diagnostic Accuracy of Chest Ultrasonography in comparison with Chest x-Ray in Detection of Community Acquired Pneumonia in under five children at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

abebe habtamu tamre, tesfaye kebede legesse, assefa getachew, tigist abate

Abstract


Background: Ultrasound (US) has been found to be safe, inexpensive, and relatively easier in diagnosing CAP in other settings and minimizes exposure to ionizing radiation. We aimed to assess the feasibility and reliability of chest US for the diagnosis of CAP as an alternative to chest radiography in a hospital setting in Ethiopia.

Methods: A prospective cross sectional study was conducted among under five children with a clinical diagnosis of pneumonia who visited the radiology department of Tikur Anbessa Specialized Hospital (TASH) for CXR examination from February to August, 2016. Relevant US findings were collected on a pretested data collection instrument and we used SPSS to analyze and compare US finding with chest radiography (used as the gold standard) finding.

Results: seventy two patients were included in the study with a mean age of 22.1 months (standard deviation ± 19.6 months) and 42 (58%) were male. We identified 44 (61%) and 48 (66%) CAP cases by CXR and chest US, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of chest US as compared to CXR were 95% (95% CI, 89-100), 86% (95% CI, 80-92), 91% (95% CI, 85-97) and 92% (95% CI, 86-98), respectively. Consolidation was found in 44 of the 48 CAP cases.

Conclusion: Chest US of the lung has a high sensitivity and specificity in identifying cases of CAP and is technically feasible. Chest US could be used as an alternative modality in the diagnosis of CAP in our setting where access to x-ray is limited.


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