Pneumonia and malaria are common causes of childhood morbidity and mortality in many developing countries and simple guidelines have been proposed to facilitate their diagnosis by relatively unskilled health workers. We have studied children in The Gambia attending out-patient and under-five clinics with clinically suspected pneumonia (cough or difficulty in breathing and a raised respiratory rate) during periods of high or low malaria transmission. During a period of high malaria transmission, 33% of these children had radiological evidence of pneumonia (with or without malaria parasitaemia) compared to 38% who had malaria parasitaemia, no radiological evidence of pneumonia and no other obvious cause of fever. Corresponding figures during a period of low malaria transmission were 48% and 6% respectively. The clinical overlap between pneumonia and malaria has important implications for case management strategies and evaluation of disease-specific interventions in regions in which both pneumonia and malaria are prevalent.
We report a case of neonatal separation of the distal humeral epiphysis in which non-invasive ultrasonic examination provided clear definition of the injury.
The radiological patterns of culture-proven pulmonary tuberculosis in 154 children under the age of 14 years were studied. Good quality radiographs were an essential requirement to the study, and in cases where lymphadenopathy was in doubt, tomograms or high kV magnification films were obtained. The radiographical terms used were defined and the results of film review were analysed to show the prevalent patterns. These are summarized at the end of the article. It is felt that awareness of the radiographic patterns in paediatric pulmonary tuberculosis will be of value to those working in communities where tuberculosis is unusual or rare, in immigrant communities, and also for the investigation of children who are inadvertently exposed to the disease.
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