Study of respiratory disease pattern in children aged 2 months-5 years admitted in a tertiary care hospital

Raja S. R., Shabin J., Mathivanan M., Muthu Rama Subramanian M.


Background: Acute respiratory infections (ARI) is one of the leading causes of under 5 mortality globally and in India. India accounts for 20% of deaths globally due to pneumonia. Reviewing the prevalence and profile of pneumonia admissions in a tertiary care hospital will reflect the burden in the community and thereby help to plan optimal use of resources and adopting proper preventive measures. Aim of study was to identify prevalence, various risk factors involved, morbidity and mortality of acute respiratory infections in children 2 months to 5 years old.

Methods: A prospective observational study conducted at a tertiary care teaching hospital of southern Tamil Nadu, India over a period of 18 months (January 2016 to June 2017). All cases between the age group of 2 months to 5 years admitted to Paediatric department were included in the study. Demographic and clinical features were recorded. Statistical analysis was done using SPSS version 22.0.

Results: A total of 2793 children were included, of which the prevalence of acute respiratory infection was 10.95% (306 children). Pneumonia was the most common diagnosis (38.5%) followed by bronchiolitis (15.3%). Mortality rate was 5.9% among the ARI cases. There was a significant influence of exclusive breast feeding and malnutrition over the morbidity and mortality of ARI cases.

Conclusions: Identifying ARI cases with risk factors for developing severe and very severe pneumonia and children with risk factors for high mortality need to be referred to tertiary care centres as early as possible for better outcome.


Pneumonia, ARI, Bronchiolitis

Full Text:



Klugman KP, Madhi SA. London: Acute Respiratory Infections. International Bank for Reconstruction and Development/The World Bank. 2006;11.

Vashishtha V. Current status of tuberculosis and acute respiratory infections in India: much more needs to be done. Indian Pediatr. 2010;47(1):88-9.

UNICEF. UNICEF Data: Monitoring the Situation of Children and Women. Available at: Accessed on 10 Jan 2020.

Fischer Walker C, Rudan I, Liu L. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013.

O’Brien KL, Wolfson LJ, Watt JP, Henkle E, Deloria-Knoll M, McCall N et al. Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates. Lancet. 2009;374(9693):893-902.

Watt JP, Wolfson LJ, O’Brien KL, Henkle E, Deloria-Knoll M, McCall N et al. Burden of disease caused by Haemophilus influenzae type b in children younger than 5 years: global estimates. Lancet. 2009;374(9693):903-11.

Ramachandran P, Nedunchelian K, Vengatesan A, Suresh S. Risk Factors for Mortality in Community-Acquired Pneumonia Among Children Aged 1-59 Months Admitted in a Referral Hospital. Indian Pediatr. 2012;49:889-95.

Chhabra P, Garg S, Mittal SK, Satyanarayan L, Mehra M, Sharma N. Magnitude of acute respiratory infections in under-fives. Indian Paediatrics. 1993;30:1315-8.

Zaman K, Baqui AH, Yunus M, Sack RB, Bateman OM, Chowdhury HR et al. Acute respiratory infections in children: A community based longitudinal study in rural Bangladesh. J Trop Paediatr. 1997;43:133-6.

Bashour HN, Webber RH, Marshall TF. A community-based study of Acute respiratory infections among preschool children in Syria. J Trop Paediatr. 1994;40:207-13.

Lamberti, Laura M. Breastfeeding for Reducing the Risk of Pneumonia Morbidity and Mortality in Children under Two: A Systematic Literature Review and Meta-Analysis. BMC Public Health. 2013;13(3):S18.

Mihrshahi S, Oddy WH, Peat JK, Kabir I. Association between infant feeding patterns and diarrhoeal and respiratory illness: a cohort study in Chittagong, Bangladesh. Int Breastfeed J. 2008;24;3:28.

Savitha MR, Nandeeshwara SB, Pradeep Kumar MJ, Ul-Haque F, Raju CK. Modifiable risk factors for acute lower respiratory tract infections. Indian J Pediatr. 2007;74(5):477-82.

Biswas A, Biswas R, Manna B, Dutta K. Risk factors of Acute respiratory infections in under-fives of urban slum community. Indian J of Public Health. 1999;43(2):73-5.