What question did this study set out to answer?

The study aims to assess the diagnostic accuracy of point-of-care ultrasound compared to clinical examination for pneumonia in children under five.

February 11, 2026Open Access

A Comparative Analysis of Point-of-Care Ultrasound and Clinical Examination for Diagnosing Pneumonia in Under-Fives at a Ugandan Regional Referral Hospital

Key Points

The study aims to assess the diagnostic accuracy of point-of-care ultrasound compared to clinical examination for pneumonia in children under five.
Cross-sectional diagnostic accuracy study design
Participants were children under five with clinical suspicion of pneumonia
Conducted clinical examination followed by POCUS by a blinded clinician
Findings were compared with a chest radiograph interpreted by a pediatric radiologist
POCUS has a sensitivity of 88% compared to 72% for clinical examination
Specificity of POCUS is 85% while clinical examination has 70%
POCUS showed significantly higher diagnostic accuracy for childhood pneumonia than clinical examination

Abstract

Pneumonia is a leading cause of death in children under five in sub-Saharan Africa. Clinical examination, the standard diagnostic method in resource-limited settings, has recognised limitations in accuracy. Point-of-care ultrasound (POCUS) is a potential alternative, but its comparative diagnostic performance in this context is not well established. This study aimed to compare the diagnostic accuracy of POCUS against clinical examination for pneumonia in children under five, using chest radiograph as a reference standard, at a regional referral hospital in Uganda. A cross-sectional diagnostic accuracy study was conducted. A consecutive sample of children under five with clinical suspicion of pneumonia underwent a standardised clinical examination, followed by POCUS performed by a trained clinician blinded to clinical findings. Findings were compared against a reference chest radiograph interpreted by a paediatric radiologist. POCUS demonstrated superior diagnostic accuracy to clinical examination. The sensitivity of POCUS was 88% (95% CI: 81–93) versus 72% (95% CI: 64–79) for clinical examination. Specificity was also higher for POCUS at 85% (95% CI: 78–90) compared to 70% (95% CI: 62–77) for clinical examination. POCUS showed significantly higher sensitivity and specificity than clinical examination for diagnosing paediatric pneumonia in this setting. POCUS should be considered for integration into paediatric assessment protocols in similar resource-limited hospitals, contingent on targeted training and sustainable equipment provision. Further research should explore implementation strategies and cost-effectiveness. point-of-care ultrasound, pneumonia, paediatrics, diagnostic accuracy, Uganda, low-resource setting This study provides original evidence on the comparative diagnostic accuracy of point-of-care ultrasound for childhood pneumonia in a typical sub-Saharan African hospital setting.

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