{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T16:49:48Z","timestamp":1759682988674,"version":"3.37.3"},"reference-count":35,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1123577"],"award-info":[{"award-number":["OPP1123577"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pneumonia and malaria are the leading causes of global childhood mortality. We describe the clinical presentation of children diagnosed with pneumonia and\/or malaria, and identify possible missed cases and diagnostic predictors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective cohort study involving children (aged 28 days to 15 years) admitted to 12 secondary\u2010level hospitals in south\u2010west Nigeria, from November 2015 to October 2017. We described children diagnosed with malaria and\/or pneumonia on admission and identified potential missed cases using WHO criteria. We used logistic regression models to identify associations between clinical features and severe pneumonia and malaria diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 16\u2009432 admitted children, 16\u2009184 (98.5%) had adequate data for analysis. Two\u2010thirds (10\u2009561, 65.4%) of children were diagnosed with malaria and\/or pneumonia by the admitting doctor; 31.5% (567\/1799) of those with pneumonia were also diagnosed with malaria. Of 1345 (8.3%) children who met WHO severe pneumonia criteria, 557 (41.4%) lacked a pneumonia diagnosis. Compared with \u201cpotential missed\u201d diagnoses of severe pneumonia, children with \u201cdetected\u201d severe pneumonia were more likely to receive antibiotics (odds ratio [OR], 4.03; 2.63\u20106.16, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), and less likely to die (OR, 0.72; 0.51\u20101.02, <jats:italic>P<\/jats:italic>\u2009=\u2009.067). Of 2299 (14.2%) children who met WHO severe malaria criteria, 365 (15.9%) lacked a malaria diagnosis. Compared with \u201cpotential missed\u201d diagnoses of severe malaria, children with \u201cdetected\u201d severe malaria were less likely to die (OR, 0.59; 0.38\u20100.91, <jats:italic>P<\/jats:italic>\u2009=\u20090.017), with no observed difference in antimalarial administration (OR, 0.29; 0.87\u20101.93, <jats:italic>P<\/jats:italic>\u2009=\u2009.374). We identified predictors of severe pneumonia and malaria diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pneumonia should be considered in all severely unwell children with respiratory signs, regardless of treatment for malaria or other conditions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.24691","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T19:57:24Z","timestamp":1582142244000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Diagnosis of pneumonia and malaria in Nigerian hospitals: A prospective cohort study"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2461-0463","authenticated-orcid":false,"given":"Hamish","family":"Graham","sequence":"first","affiliation":[{"name":"Centre for International Child Health, MCRI, Royal Children's Hospital University of Melbourne Parkville Victoria Australia"},{"name":"Department of Paediatrics University College Hospital Ibadan Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2456-7899","authenticated-orcid":false,"given":"Ayobami A.","family":"Bakare","sequence":"additional","affiliation":[{"name":"Department of Community Medicine University College Hospital Ibadan Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1772-1798","authenticated-orcid":false,"given":"Adejumoke I.","family":"Ayede","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University College Hospital Ibadan Nigeria"},{"name":"Department of Paediatrics University of Ibadan Ibadan Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oladapo B.","family":"Oyewole","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University College Hospital Ibadan Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0127-0769","authenticated-orcid":false,"given":"Amy","family":"Gray","sequence":"additional","affiliation":[{"name":"Centre for International Child Health, MCRI, Royal Children's Hospital University of Melbourne Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7998-0942","authenticated-orcid":false,"given":"Eleanor","family":"Neal","sequence":"additional","affiliation":[{"name":"Centre for International Child Health, MCRI, Royal Children's Hospital University of Melbourne Parkville Victoria Australia"},{"name":"Infection &amp; Immunity, MCRI Royal Children's Hospital Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shamim A.","family":"Qazi","sequence":"additional","affiliation":[{"name":"Department of Maternal, Newborn, Child and Adolescent Health World Health Organization Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trevor","family":"Duke","sequence":"additional","affiliation":[{"name":"Centre for International Child Health, MCRI, Royal Children's Hospital University of Melbourne Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8216-2924","authenticated-orcid":false,"given":"Adegoke G.","family":"Falade","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University College Hospital Ibadan Nigeria"},{"name":"Department of Paediatrics University of Ibadan Ibadan Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization.WHO Global Health Observatory Data Repository 2019. 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