Research Article Radiologic Diagnosis and Hospitalization among Children with Severe Community Acquired Pneumonia: A Prospective Cohort Study Meiron Hassen, 1,2 Alemayehu Toma, 3 Mulugeta Tesfay, 4 Eyoel Degafu, 5 Solomon Bekele, 6 Freshwork Ayalew, 7 Abel Gedefaw, 8 and Birkneh Tilahun Tadesse 2 1 Adare General Hospital, Pediatrics Unit, Hawassa, Ethiopia 2 Hawassa University, College of Medicine and Health Sciences, Department of Pediatrics and Child health, Hawassa, P.O. Box 1560, Ethiopia 3 Hawassa University, College of Medicine and Health Sciences, School of Pharmacy, Department of Pharmacology and Toxicology, Hawassa, P.O. Box 1560, Ethiopia 4 Bete-Abrham Primary Hospital, Department of Radiology, Hawassa, P.O. Box 851, Ethiopia 5 Alatyon General Hospital, Department of Radiology, Hawassa, P.O. Box 1267, Ethiopia 6 Hawassa University, College of Medicine and Health Sciences, Department of Radiology, Hawassa, P.O. Box 1560, Ethiopia 7 Hawassa University, College of Medicine and Health Sciences, School of Laboratory Medicine, Hawassa, P.O. Box 1560, Ethiopia 8 Hawassa University, College of Medicine and Health Sciences, Department of Gynecology and Obstetrics, Hawassa, P.O. Box 1560, Ethiopia Correspondence should be addressed to Birkneh Tilahun Tadesse; birknehtilahun@gmail.com Received 15 November 2018; Revised 13 December 2018; Accepted 20 December 2018; Published 9 January 2019 Academic Editor: Jonathan Muraskas Copyright © 2019 Meiron Hassen et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives. Tis study was designed to assess the role of chest radiography for the diagnosis of pneumonia and assess the association of clinical characteristics with radiologic fndings and predictors of hospitalization among children with severe community acquired pneumonia. Methods. A prospective study was conducted on 122 children between ages of 3 month and 14 years admitted to pediatric emergency unit with diagnosis of severe pneumonia from September 1 st to November 30 th , 2017. Eligible children were subjected to chest radiography which was read by two senior radiologists independently (R1 and R2). Disagreements between R1 and R2 were resolved by a third senior radiologist (R3). Level of agreement between radiologists was assessed using Cohen’s kappa coefcient. Clinical and laboratory parameters which could explain the variability in the duration of hospital stay were assessed using a linear regression mode. Independent predictors were assessed using multiple linear regression. Results. Te median age of the cohort was 10.0 months (interquartile range (IQR): 6.75–24.0); 76 (62.3%) were male. Nearly half, 63 (51.6%) did not have radiologic evidence of pneumonia. Tere was low level of agreement between R1 and R2 in reporting consolidation (kappa=0.435, p-value≤0.001), haziness (kappa=0.375, p-value≤0.001), and infltration (kappa=0.267, p-value=0.008). Children with higher recorded temperature were more likely to have radiologic abnormalities suggesting pneumonia (p-value=0.033). Te median duration of hospitalization was 3 days (IQR: 1-4 days); 118 (96.7%) were discharged with improvement. Height-for-age z-score (Coef.=0.203, R 2 =0.041, p- value=0.027); and hemoglobin level (Coef.=-0.249, R 2 =0.062, p-value=0.006) explained 4.1% and 6.2% of the variability in the duration of hospital stay, respectively. Conclusion. Radiologic evidence of pneumonia was absent in half of the children with severe pneumonia. Tere was low agreement between senior radiologists in reporting chest radiographic fndings, potentially necessitating harmonization activities to uniformly implement the WHO guidelines in reading chest radiographs. 1. Background Worldwide, pneumonia was responsible for 15% of childhood deaths in 2016, with highest incidence in developing countries [1]. Te global annual incidence of pneumonia is 150 to 156 million cases, accounting for approximately 10-20 million hospitalizations [1]. In Ethiopia, acute respiratory tract infec- tions, particularly pneumonia, are the leading causes of child Hindawi BioMed Research International Volume 2019, Article ID 6202405, 8 pages https://doi.org/10.1155/2019/6202405