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Published on: March 6, 2019
Childhood pneumonia diagnostics: a narrative review
Olutobi Ojuawo1, Ayotade Ojuawo2, Adeniyi Aladesanmi3
1Global Health Department, Liverpool School of Tropical Medicine, Liverpool, UK.
Insights
Diagnosing childhood pneumonia is challenging, leading to antibiotic overuse and resistance. Emerging tools like lung ultrasound and advanced lab tests show promise but need more research for accurate bacterial vs. viral identification.
Area of Science:
- Pediatrics
- Infectious Diseases
- Diagnostic Imaging
- Biochemistry
Background:
- Childhood pneumonia is a leading infectious cause of death globally, particularly in low- and middle-income countries.
- Distinguishing bacterial from viral pneumonia is difficult, leading to widespread antibiotic overuse.
- Antimicrobial resistance is a growing concern, exacerbated by inappropriate antibiotic use in pediatric pneumonia cases.
Purpose of the Study:
- To review current and emerging diagnostic modalities for childhood pneumonia.
- To evaluate the strengths and limitations of various diagnostic techniques.
- To assess the ability of these modalities to differentiate between bacterial and viral pneumonia.
Main Methods:
- Literature review of existing diagnostic tools.
- Evaluation of radiological techniques, including lung ultrasonography.
- Assessment of emerging laboratory methods such as serum biomarkers, gene expression arrays, and metabolomic analysis.
Main Results:
- Optimal diagnosis of childhood pneumonia remains a significant challenge.
- Lung ultrasonography presents a promising non-invasive imaging approach.
- Advanced biochemical analyses, including biomarkers and omics technologies, are emerging for improved diagnostics.
Conclusions:
- Accurate diagnosis is crucial for effective treatment and antimicrobial stewardship.
- Newer diagnostic modalities require further research and validation.
- Improved diagnostics are essential to combat rising antimicrobial resistance in childhood pneumonia.
Background:
Childhood pneumonia remains the leading infectious cause of death in children with highest mortality figures in sub-Saharan Africa and Southeast Asia. The primary etiologies are bacterial and viral; however, challenges in distinguishing bacterial and non-bacterial causes have culminated in antimicrobial overuse which has partly contributed to the rise in antimicrobial resistance, most notably among children in low- and middle-income countries.
Areas Covered:
Existing literature was reviewed regarding modalities available, including emerging radiological and laboratory techniques, to diagnose childhood pneumonia. We evaluated their strengths and limitations, and their ability to distinguish between bacterial and viral etiologies.
Expert Opinion:
The optimal modality to diagnose childhood pneumonia continues to be a challenge. This is a concern given its high disease burden and the importance of diagnostics for clinical care and antimicrobial stewardship, in the setting of rising antimicrobial resistance. Lung ultrasonography is a promising radiologic diagnostic modality. Combined serum biomarkers, micro-array-based whole-genome expression arrays and metabolomic analysis are also emerging biochemical modalities for childhood pneumonia diagnosis. More research and further validation are required to evaluate the diagnostic strengths of these new and emerging modalities as well as their ability to discriminate between the major etiologies of the disease.
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