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To develop a case definition for the Pneumonia Etiology Research for Child Health (PERCH) project, we sought a widely acceptable classification that was linked to existing pneumonia research and focused on very severe cases. We began with the World Health Organization's classification of severe/very severe pneumonia and refined it through literature reviews and a 2-stage process of expert consultation. PERCH will study hospitalized children, aged 1-59 months, with pneumonia who present with cough or difficulty breathing and have either severe pneumonia (lower chest wall indrawing) or very severe pneumonia (central cyanosis, difficulty breastfeeding/drinking, vomiting everything, convulsions, lethargy, unconsciousness, or head nodding). It will exclude patients with recent hospitalization and children with wheeze whose indrawing resolves after bronchodilator therapy. The PERCH investigators agreed upon standard interpretations of the symptoms and signs. These will be maintained by a clinical standardization monitor who conducts repeated instruction at each site and by recurrent local training and testing.

Original publication

DOI

10.1093/cid/cir1065

Type

Journal article

Journal

Clin Infect Dis

Publication Date

04/2012

Volume

54 Suppl 2

Pages

S109 - S116

Keywords

Algorithms, Child Welfare, Child, Hospitalized, Child, Preschool, Cough, Developing Countries, Dyspnea, Epidemiologic Research Design, Humans, Infant, Patient Selection, Pneumonia, Risk Assessment, Severity of Illness Index, World Health Organization