Study of risk factors leading to poor outcomes in severe pneumonia age 2M-60M in a tertiary care hospital
DOI:
https://doi.org/10.18203/2349-3291.ijcp20192026Keywords:
Risk factors, Severe pneumoniaAbstract
Background: Childhood pneumonia is the single leading cause of mortality in children aged less than 5 years. Most cases occur in India (43 million); pneumonia is responsible for about 19% of all deaths in children aged less than 5 years. According to Child Health and Epidemiology Reference Group (CHERG) latest estimates, Pneumonia was responsible for 0.397 million of a total estimated 1.682 million under-five deaths in India.
Methods: A hospital based prospective longitudinal study. In the present study 200 cases belong to age group 2 months to 5 years fulfilling WHO criteria for pneumonia who were attended to the department of paediatrics, Siddhartha medical college from January 2017 to January 2018 were evaluated the risk factors in relation to their outcomes after obtaining consent
Results: Out of 200 children with severe pneumonia 11 risk factors are studied for significance against outcomes like Death of the patient, mechanical ventilation oxygen supplementation, hospital stay of patient and total duration of illness, Risk factors found to be significant are maternal literacy (p =0.0002617), malnutrition (p <0.00001), exclusive breastfeeding (p <0.05), low birth weight (p <0.05), immunisation (p=0.01).
Conclusions: Severe malnutrition, maternal illiteracy, exclusive breast feeding, improper immunization and low birth weight are having a significant association with poor outcomes in children with severe pneumonia. Proper preventive strategies to decrease the incidence of these risk factors can help in increasing the survival rate of children with severe pneumonia.
References
Bansal S, Kashyap S, Pal LS, Goel A. Clinical and bacteriological profile of Community-acquired pneumonia in Shimla, Himachal Pradesh. Indian J Chest Dis Allied Sci. 2004;46:17-22.
Diaz A, Barria P, Niederman M, Restrepo MI, Dreyse J, Fuentes G, et al. Etiology of community-acquired pneumonia in hospitalised patients in Chile: The Increasing prevalence of respiratory viruses among classic pathogens. Chest. 2007;131:779-87.
Javed S, Chaudhry R, Passi K, Sharma S, KP Dhawan B, Dey AB. Serodiagnosis of Legionella infection in community-acquired pneumonia. Indian J Med Res. 2010 Jan;131:92-6.
Shah BA, Singh G, Naik MA, Dhobi GN. Bacteriological and clinical profile of Community-acquired pneumonia in hospitalized patients. Lung India. 2010;27:54-7.
Müller B, Harbarth S, Stolz D, Bingisser R, Mueller C, Leuppi J, et al. Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia. BMC Infect Dis. 2007;7(1):10.
Metlay J P, Fine M J. Testing strategies in the initial management of a patient with community-acquired pneumonia. Ann Intern Med. 2003;138:109-18.
Kyriacou DN, Yarnold PR, Soltysik RC, Self WH, Wunderink RG, Schmitt BP, et al. Derivation of a triage algorithm for chest radiography of community-acquired Pneumonia patients in the emergency department. Acad Emerg Med. 2008;15:40-4.
Metlay JP, Schulz R, LiYH, Singer DE, Marrie TJ, Coley CM, et al. Influence of age on symptoms at presentation in patients with community acquired pneumonia. Arch Intern Med. 1997;157:1453-9.
Seaton A, Seaton D. and AG Leich, Crofton & Douglas’s. Respiratory Diseases. 5th ed. 2008:356-429.
Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organization. 2008;86:408-16B.
Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379(9832):2151-61.
National health profile. Government of India, DGHS, Ministry of health and family welfare, New Delhi. 2011.
