Clinical sign and biomarker-based algorithm to identify bacterial pneumonia among outpatients with lower respiratory tract infection in Tanzania

Table 1 Baseline characteristics, vital signs, management and outcome of patients according to the diagnosis

	All (n = 110)	Bacterial CAP (n = 17)	Viral CAP (n = 8)	CAP of unknown origin (n = 7)	Bronchitis (n = 78)	p-value
Age, years	29 (23–39)	28 (24–35)	31 (29–51)	33 (32–64)	29 (21–38)	0.051
Female sex	58 (53)	8 (47)	3 (38)	2 (29)	45 (58)	0.338
HIV-1infection	36 (33)	13 (76)	4 (50)	1 (14)	18 (23)	0.000
Co-infection	22 (20)	2 (12)	1 (13)	1 (14)	18 (23)	0.658
- Malaria	7 (6.4)	1 (5.9)	0 (0)	0 (0)	6 (7.7)	0.739
- Dengue	7 (6.4)	0 (0)	0 (0)	0 (0)	7 (9.0)	0.381
- Other	9 (8.2)^a	1 (5.9)	1 (13)	1 (14)	6 (7.7)	0.875
Sepsis / septic shock^b	27 (25)	5 (35)	1 (13)	1 (14)	20 (26)	0.731
Symptoms and signs
Cough	103 (94)	17 (100)	8 (100)	6 (86)	72 (92)	0.446
Dyspnoea	27 (25)	6 (35)	1 (13)	2 (29)	18 (23)	0.606
Chest pain,	25 (23)	4 (24)	3 (38)	2 (29)	16 (21)	0.716
Respiratory rate, /min	25 (23–29)	34 (26–37)	26 (25–34)	24 (23–26)	24 (22–26)	0.000
Abnormal auscultation	29 (26)	8 (47)	2 (25)	2 (29)	17 (22)	0.202
Saturation, %	97 (96–98)	95 (93–96)	96 (94–96)	97 (96–98)	97 (96–98)	0.000
Systolic BP, mmHg	117 (104–123)	100 (97–107)	119 (109–123)	126 (120–132)	118 (104–124)	0.000
Heart rate, /min	108 (92–120)	129 (117–138)	115 (104–120)	98 (82–108)	106 (89–115)	0.000
Pneumonia clinical scores
CRB-65 score^c ≥ 2	12 (11)	5 (29)	1 (13)	0 (0)	6 (7.7)	0.053
Van Vugt-score^d, high	68 (62)	16 (94)	6 (75)	4 (57)	42 (54)	0.016
Management and outcome
Admission	20 (18)	7 (41)	2 (25)	2 (29)	9 (12)	0.028
Antibiotic prescription	55 (50)	16 (94)	7 (88)	4 (57)	28 (36)	0.000
28-day mortality	6 (5.5)	2 (12)	1 (13)	0 (0)	3 (3.9)	0.411

Bold values indicate a significant difference between the groups
Data are number (%) of patients or median (interquartile range)
Bacterial CAP: community-acquired pneumonia with a bacterial aetiology detected; viral CAP: community-acquired pneumonia with a viral aetiology detected. CAP of unknown origin: community-acquired pneumonia without microbiological documentation
^a1 adenovirus gastro-enteritis, 3 urogenital infections, 2 West nile, 1 intraabdominal infection, 2 ricketsioses, 2 gastroenteritis of unknown origin. ^bSepsis or septic shock defined as a sofa score of ≥ 2 points. ^cCRB-65 score defined as one point for each of the following: Glasgow Coma Score < 15, respiratory rate ≥ 30/min, systolic blood pressure < 90 mmHg or diastolic blood pressure ≤ 60 mmHg, age ≥ 65. ^dVan Vugt score was defined as one point for each of the following: absence of runny nose, presence of dyspnea, presence of crackles or diminished breath by auscultations, temperature ≥ 37.8 °C or heart rate > 100/min. High score was defined as ≥ 3 points

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