Is pneumonia among children in developing countries a different disease from the 1 among patients in the same age group in developed countries?

摘要

The study by Wingerter et al1 assessed the utility of the World Health Organization (WHO) clinical criteria2 to identify children warranting treatment with antibiotics for possible pneumonia. It found a substantial proportion (65%) of children ^5 years of age presenting to an urban, United States, emergency room with suspected community-acquired pneumonia who were found to have radiologic findings on chest radiograph (CXR) and were not identified by the WHO clinical screening criteria that rely on age specific elevated respiratory rates. The authors speculate that pneumonia in a developed, high access to care setting may be a "different disease" from that of developing countries, the primary target for the WHO screening criteria. Several important questions warrant further analysis, discussion and interpretation.