Instrument for Assessing Respiratory Disorders in Children: A Systematic Review

Authors

DOI:

https://doi.org/10.37287/ijghr.v8i1.588

Keywords:

asthma, pneumonia, respiratory index of severity in children, RISC scoring system, test for respiratory and asthma control in kids

Abstract

Respiratory disorders remain the most common cause of morbidity and mortality in children under 5 years of age worldwide. Pneumonia and asthma are part of this. To reduce pediatric mortality, valid and reliable instruments are needed to guide the further treatment process appropriately. This systematic review aimed to identify the sensitivity and specificity of the Respiratory Index of Severity in Children (RISC) and Test for Respiratory and Asthma Control in Kids (TRACK) instruments in children with pneumonia and asthma. The study was conducted by searching articles from the online databases PubMed, Scopus, JSTOR, ProQuest, Science Direct, and EBSCOhost from 2015 to 2025. Two reviewers independently assessed the study quality using QUADAS-2. Of the 969 articles found, 6 articles were selected for  analysis. The RISC instrument obtained various sensitivity values with a cut-off ≥3, namely 21.3% to 94.1% and specificity values of 73.6% to 89.51%. In the TRACK instrument, the sensitivity values ranged from 75.6% to 81.4% and the specificity values ranged from 70.9% to 80.0% using a cut-off of 80. Both instruments can be used to assess the severity and mortality risk of childhood pneumonia and the assessment of asthma symptoms and control in children.

References

Alamneh, Y. M., & Adane, F. (2020). Magnitude and predictors of pneumonia among under-five children in Ethiopia: A systematic review and meta-analysis. Journal of Environmental and Public Health, 2020. https://doi.org/10.1155/2020/1606783

Arslan, Q., Qayyum, Z., Yousafzai, U. S. K., Alamgeer, M. S., Malik, S., & Awan, H. A. (2025). Diagnostic accuracy of the Respiratory Index of Severity in Children (RISC) score for mortality prediction and severity assessment in community-acquired pneumonia among 1–5-year-olds. Journal of Health, Wellness and Community Research, e638. https://doi.org/10.61919/9b8q7q90

Choi, Y. J., Jang, G. C., Yang, H. J., Kim, H. Bin, Yoo, Y., Shin, M., Lee, S. Y., Kim, J., Kim, W. K., Suh, D. I., & Koh, Y. Y. (2019). The Korean version of the Test for Respiratory and Asthma Control in Kids (TRACK): Reliability and validity. Journal of Korean Medical Science, 34(3). https://doi.org/10.3346/jkms.2019.34.e25

Ebeledike, C., & Ahmad, T. (2023). Pediatric Pneumonia. StatPearls.

Kapoor, A., Awasthi, S., & Yadav, K. K. (2022). Predicting mortality and use of RISC scoring system in hospitalized under-five children due to WHO defined severe community acquired pneumonia. Journal of Tropical Pediatrics, 68(4), 1–10. https://doi.org/10.1093/tropej/fmac050

Kementerian Kesehatan Republik Indonesia. (2024). Profil Kesehatan Indonesia 2023.

Leiria-Pinto, P., Marques, J., Finelli, E., Alves, C., Alves, M., Trincão, D., Pinto, N., Carreiro-Martins, P., Papoila, A. L., & Neuparth, N. (2021). Cross-cultural validation of the Portuguese from Portugal version of the Test for Respiratory and Asthma Control in Kids (Track) questionnaire. European Annals of Allergy and Clinical Immunology, 53(5), 214–220. https://doi.org/10.23822/EurAnnACI.1764-1489.174

Lestari, N. P., Oktaria, V., Aryanto, S., & Wiratama, B. S. (2025). Assessment of 2021 surveillance system for under-five children with pneumonia in Bantul Regency, Indonesia. Clinical Epidemiology and Global Health, 32. https://doi.org/10.1016/j.cegh.2025.101958

Liu, L., Zhang, J., Zhang, L., Yuan, S. H., Wu, J. H., Tang, M. Y., Chen, J. De, Zhang, F., Qi, X. Y., & Yin, Y. (2021). The relationship of the test for respiratory and asthma control in kids initial score on the prognosis of pre-school children with asthma: A prospective cohort study. Frontiers in Pediatrics, 9. https://doi.org/10.3389/fped.2021.690333

Megied, M. A. A. El, Motey, M. A. F. A., Aziz, M. M., & Ebrahim, M. M. (2023). Diagnostic and predictive value of Respiratory Index of Severity in Children (RISC) scoring system in community-acquired pneumonia: A prospective cross sectional study. Egyptian Pediatric Association Gazette, 71(1). https://doi.org/10.1186/s43054-023-00170-1

Nasrin, S., Tariqujjaman, M., Sultana, M., Zaman, R. A., Ali, S., Chisti, M. J., Faruque, A. S. G., Ahmed, T., Fuchs, G. J., Gyr, N., & Alam, N. H. (2022). Factors associated with community acquired severe pneumonia among under five children in Dhaka, Bangladesh: A case control analysis. PLoS ONE, 17(3 March). https://doi.org/10.1371/journal.pone.0265871

Odo, D. B., Yang, I. A., Dey, S., Hammer, M. S., van Donkelaar, A., Martin, R. V., Dong, G. H., Yang, B. Y., Hystad, P., & Knibbs, L. D. (2022). Ambient air pollution and acute respiratory infection in children aged under 5 years living in 35 developing countries. Environment International, 159. https://doi.org/10.1016/j.envint.2021.107019

Pillai, K., Sartho, E. R., Lakshmi, T. P., & Parvathy, V. K. (2021). Diagnosis and assessment of severity of pediatric pneumonia using the Respiratory Index of Severity (RISC) scoring system. INDIAN PEDIATRICS, 58, 2021.

Pranathi, B. S., Lakshminarayana, S. K., Kumble, D., Rangegowda, R. K., Kariyappa, M., & Chinnappa, G. D. (2023). A Study of the Clinical Profile and Respiratory Index of Severity in Children (RISC) Score in Infants Admitted With Acute Respiratory Infections at a Tertiary Care Hospital. Cureus. https://doi.org/10.7759/cureus.43100

Ramavat, S., Chaudhary, D., Singh, L., & Bhatnagar, S. (2023). Predictive value of Respiratory Index of Severity in Children (RISC) in children with lower respiratory tract infections. Pakistan Heart Journal, 02(56). http://www.pkheartjournal.com

Sarikloglou, E., Fouzas, S., & Paraskakis, E. (2024). Prediction of asthma exacerbations in children. In Journal of Personalized Medicine (Vol. 14, Issue 1). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/jpm14010020

Singh, R. K., & Kamble, M. B. (2020). Applicability of respiratory severity score and modified TAL criteria in pediatric age group for grading and management of acute respiratory illness. International Journal of Contemporary Pediatrics, 7(3), 532. https://doi.org/10.18203/2349-3291.ijcp20200676

Tewary, S., De, S., & Khawash, P. (2023). Evaluation of risk factors for morbidity and mortality in children aged 1 month- 6 years presenting with lower respiratory tract infection to a referral hospital. International Journal of Contemporary Pediatrics, 10(5), 663–671. https://doi.org/10.18203/2349-3291.ijcp20231141

UNICEF. (2024). Pneumonia: A child dies of pneumonia every 43 seconds.

Verma, E., Das, I., & Das, A. (2023). Respiratory index of severity in children score for assessment of severity in pediatric pneumonia- a hospital-based study. International Journal of Research in Medical Sciences, 11(5), 1582–1586. https://doi.org/10.18203/2320-6012.ijrms20231319

Wandalsen, G. F., Dias, R. G., Chong-Neto, H. J., Rosário, N., Moraes, L., Wandalsen, N. F., Medeiros, D., Bianca, A. C. Della, Urrutia-Pereira, M., Avila, J., Jorge, P. P., & Solé, D. (2018). Test for Respiratory and Asthma Control in Kids (TRACK): Validation of the Portuguese version. World Allergy Organization Journal, 11(1). https://doi.org/10.1186/s40413-018-0219-y

WHO. (2022). Pneumonia in children.

WHO. (2024). World health statistics 2024: Monitoring health for the SDGs, sustainable development goals.

Windi, R., Efendi, F., Qona’ah, A., Adnani, Q. E. S., Ramadhan, K., & Almutairi, W. M. (2021). Determinants of acute respiratory infection among children under-five years in Indonesia. Journal of Pediatric Nursing, 60, e54–e59. https://doi.org/10.1016/j.pedn.2021.03.010

Wu, H. fan, Chen, A. C., & Wei, C. C. (2024). Correlation between impulse oscillometry parameters and Test for Respiratory and Asthma Control in Kids (TRACK) in asthma control of preschoolers with asthma. Journal of the Formosan Medical Association, 123(3), 366–373. https://doi.org/10.1016/j.jfma.2023.08.028

Zhang, J., Zhao, L., Zhao, D., Chen, Z., Li, S., Zhang, H., Zhang, L., Yuan, S., Tang, M., Wu, Y., Zhong, W., Xu, J., Zhao, L. X., Liu, S. Y., Hong, J., & Yin, Y. (2019). Reliability and validity of the Chinese version of the Test for Respiratory and Asthma Control in Kids (TRACK) in preschool children with asthma: A prospective validation study. BMJ Open, 9(8). https://doi.org/10.1136/bmjopen-2018-025378.

Downloads

Published

2026-02-19

How to Cite

Putri S, L. T. Y., Huda, M. H., Astuti, A., Nugroho, A., & Wanda, D. (2026). Instrument for Assessing Respiratory Disorders in Children: A Systematic Review. Indonesian Journal of Global Health Research, 8(1), 851–858. https://doi.org/10.37287/ijghr.v8i1.588

Similar Articles

<< < 21 22 23 24 25 26 27 28 29 30 > >> 

You may also start an advanced similarity search for this article.