Comparison of Diagnostic Performance of Lung Ultrasonography and Chest Radiography in Diagnosing Respiratory Distress Syndrome in Neonates: A diagnostic study at Muhimbili National Hospital

Background: Lung ultrasound (LUS) has emerged as a potential modality of choice for diagnosing respiratory distress syndrome (RDS), which has shown high sensitivity and specificity. Aim: This study aimed to determine the diagnostic performance of Lung ultrasound (LUS) compared to chest radiography (CXR) in the diagnosis of RDS and associated risk factors among neonates at Muhimbili National Hospital (MNH). Methodology: Quantitative cross-sectional study was conducted at MNH between June to December 2022. A sample of 179 neonates meeting the inclusion criteria was obtained through consecutive sampling. Demographic and clinical information was obtained using a structured data collection and monitoring tool. Data analysis was done using SPSS version 23, descriptive statistics, sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV), univariate and multivariate logistic regression were employed. Significance was determined at p-value < 0.05. Results: 179 neonates were studied (mean gestational age (GA): 32 ± 4 weeks, mean birth weight: 1,769 ± 856 g) and 103 newborns had a final diagnosis of RDS. LUS compared to CXR showed high sensitivity, specificity, PPV, NPV and diagnostic accuracy in diagnosing RDS, 95.1% vs. 90.3%, 94.7% vs. 89.5%, 96.1% vs. 92.1%, 93.5% vs. 87.2%, 95% vs. 90% respectively. Multivariable analyses demonstrated risk factors significantly associated with RDS were GA (p-value=0.01), low birth weight (LBW) (p-value=0.034), and small for gestational age, (p-value=0.034). Conclusion: Lung ultrasonography compared to chest radiography was found to have high diagnostic accuracy, sensitivity, specificity, PPV and NPV for RDS in neonates. RDS was significantly associated with LBW, GA, and SGA.