Prevalence of chest radiograph findings in neonates with respiratory distress at Kenyatta National Hospital

Abstract

Background: Most of the global neonatal deaths from pulmonary infections occur in the developing nations. The main imaging used in the diagnosis and follow-up of these patients is the chest radiograph.
Objective: To describe the prevalence of chest radiographic findings in neonates with signs and symptoms of respiratory distress admitted at the newborn unit of Kenyatta National Hospital.
Design: Descriptive cross-sectional study.
Subjects: Neonates aged 1-30 days with clinical signs of respiratory distress and available chest radiograph during the study period.
Results: Using consecutive sampling, a total of 100 neonates with clinical signs of respiratory distress and available chest radiographs were recruited following ethical approval and parental informed consent. The male to female ratio was 1.04:1. The median age of neonates studied was 5.3 days (range 1 to 30 days). The mean birthweight was 2.1 kilograms (SD=0.9). Twenty-three percent (23%) of the study population were premature. The chest radiograph patterns were normal in 39% and abnormal in 61%. The abnormal chest findings were “other infiltrate” in 47% and alveolar consolidation in 14%. The most common causes of respiratory distress using radiographic features were respiratory distress syndrome (41.1%), transient tachypnoea of the newborn (16.8%) and neonatal pneumonia (15.8%). Non-pulmonary causes of respiratory distress were diagnosed in six neonates who presented with congenital heart disease (3), metabolic disorders (2) and choanal atresia (1).

Conclusion: From the neonatal chest radiograph findings; most neonates present with medical causes of respiratory distress of which  the most common radiographic presentation was “other infiltrate”