{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:32:57Z","timestamp":1789018377583,"version":"build-2803163510"},"reference-count":46,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2020,5,7]],"date-time":"2020-05-07T00:00:00Z","timestamp":1588809600000},"content-version":"unspecified","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1118005"],"award-info":[{"award-number":["OPP1118005"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,4,21]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The current study was a hospital-based surveillance of cases hospitalised with WHO-defined community-acquired pneumonia in children aged 2\u201359 months, to assess the radiological abnormalities in chest X-rays and to identify the demographic and clinical correlates of specific radiological abnormalities, in residents of prespecified districts of Uttar Pradesh and Bihar, India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective, active, hospital-based surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Multisite study conducted in a network of 117 secondary\/tertiary care hospitals in four districts of Uttar Pradesh and Bihar, India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Included were children aged 2\u201359 months, hospitalised with community-acquired pneumonia, residing in the project district, with duration of illness &lt;14 days and who had not been hospitalised elsewhere for this episode nor had been recruited previously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measure<\/jats:title>\n                    <jats:p>Concordant radiological abnormalities in the chest X-rays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From January 2015 to April 2017, 3214 cases were recruited and in 99.40% (3195\/3214) chest X-rays were available, among which 88.54% (2829\/3195) were interpretable. Relevant radiological abnormalities were found in 34.53% (977\/2829, 95% CI 32.78 to 36.28). These were primary end point pneumonia alone or with other infiltrates in 22.44% (635\/2829, 95% CI 20.90% to 23.98%) and other infiltrates in 12.09% (342\/2829; 95% CI 10.88% to 13.29%). There was a statistically significant interdistrict variation in radiological abnormalities. Statistically significantly higher proportion of abnormal chest X-rays were found in girls, those with weight-for-age z-score \u2264\u22123SD, longer duration of fever, pallor and with exposure to biomass fuel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among hospitalised cases of community-acquired pneumonia, almost one-third children had abnormal chest radiographs, which were higher in females, malnourished children and those with longer illnesses; and an intra-district variation was observed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-034066","type":"journal-article","created":{"date-parts":[[2020,5,8]],"date-time":"2020-05-08T07:36:30Z","timestamp":1588923390000},"page":"e034066","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Chest radiograph findings in children aged 2\u201359 months hospitalised with community-acquired pneumonia, prior to the introduction of pneumococcal conjugate vaccine in India: a prospective multisite observational study"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1254-9802","authenticated-orcid":false,"given":"Shally","family":"Awasthi","sequence":"first","affiliation":[{"name":"Department of Pediatrics, King George's Medical University, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuhina","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King George's Medical University, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King George's Medical University, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Radio-diagnosis, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namita","family":"Mohindra","sequence":"additional","affiliation":[{"name":"Department of Radio-diagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram Chandra","family":"Shukla","sequence":"additional","affiliation":[{"name":"Department of Radio-diagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Public Health, King George's Medical University, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandra Mani","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Biostatistics & Health Informatics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neera","family":"Kohli","sequence":"additional","affiliation":[{"name":"Department of Radio-diagnosis, King George's Medical University, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CAP","family":"Study Group","sequence":"additional","affiliation":[{"name":"CAP Study Group, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,5,7]]},"reference":[{"key":"2025121219283904000_10.5.e034066.1","unstructured":"UNICEF U . 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