Summary: | Background: Pneumonia is a leading cause of mortality and morbidity in children in the
world. Integrated Management of Childhood Illnesses (IMCI) recommends to use fast
breathing and chest indrawing as the approach to manage pneumonia, but the diagnostic
value has not been evaluated in Indonesia.
Objective: To determine the diagnostic value of fast breathing and chest indrawing for
diagnosing pneumonia in children
Methods: A cross sectional study was conducted in outpatient clinic and Emergency
Departement RSUP Dr. Sardjito, Yogyakarta, from October 2011-January 2012 . Children
aged 2 months to 5 years with cough and or breathing difficulty were recruited to the study.
Fast breathing and chest indrawing were assessed by a trained doctor. All eligible children
underwent chest X-ray as the gold standard of pneumonia.
Result: Of the 85 eligible subject, 32 (37.6%) were diagnosed as pneumonia. Fast breathing
had a sensitivity of 56%, specificity 64%, positive predictive value (PPV) 49%, negative predictive
value (NPV) 71%, positive likelihood ration (PLR) 1.57 and negative likelihood ration (NLR) 0.68.
Chest indrawing had a sensitivity of 44%, specificity 64%, PPV 42%,NPV 65%, PLR 1.22 dan NLR
0.88. Combination of fast breathing and chest indrawing had sensitivity of 31%, specificity 83%,
PPV 53%, NPV 67%, PLR 1.84 and NLR 0.83.
Conclusion: The diagnostic values of fast breathing and chest indrawing for pneumonia is
modest. The combination of both parameter improves the sensitivity.
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