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Table 2 Examples of varying definitions of severe pneumonia depending on purpose

From: Acute respiratory infection and bacteraemia as causes of non-malarial febrile illness in African children: a narrative review

Source

Very severe pneumonia

Severe pneumonia

Purpose

WHO [25]

CDB+ multiple convulsions or coma or lethargy or vomiting everything or inability to drink or cyanosis or severe respiratory distress

CDB+ chest indrawing

Treatment of children with suspected pneumonia

Cutts et al [34]

 

Clinically suspected pneumonia with radiological opaque or fluffy opacities in part or all of a lobe of the lung or pleural effusion

Clinical trial of pneumococcal vaccine

Nokes et al [35]

As severe but >2 criteria needed

CDB+ >1 of: intercostal indrawing, inability to feed, increased RR for age, SPO2 <90%

Epidemiological description of admitted cases

Scott et al [33]

CDB+ any of: hypoxaemia (SPO2 <90%), inability to feed, head nodding, or impaired consciousness

CDB+ chest indrawing

Epidemiological description of admitted cases

Nair et al [23]

As severe, + any IMCI danger sign or hypoxaemia (SPO2 <90%)

CDB+ admitted to hospital

Estimation of global burden

Mulholland et al [36]

Invasive Hib disease verified by positive isolate from blood or CSF culture

 

Randomised clinical trial of Hib vaccine

  1. CDB+, cough/difficulty breathing plus; IMCI, integrated management of childhood illnesses; SpO2, saturation of peripheral oxygen; RR, respiratory rate; Hib, Haemophilus influenzae type b; CSF, cerebral spinal fluid; WHO, World Health Organization