Clinical and aetiological profile of Pneumonia in age group between 1 month to 1 year: a hospital based prospective study

Authors

  • Vamsee Krishna Polepalli Department of Paediatrics, Santhiram Medical College, Nandyal, Andhra Pradesh, India
  • Naveen Kumar Banda Department of Paediatrics, Ananthapur Medical College, Ananthapur, Andhra Pradesh, India
  • Y. Venu Gopal Sarma Department of Paediatrics, Santhiram Medical College, Nandyal, Andhra Pradesh, India
  • K. V. Siva Rama Krishna Department of Paediatrics, Santhiram Medical College, Nandyal, Andhra Pradesh, India
  • M. Hima Bindu Department of Paediatrics, Santhiram Medical College, Nandyal, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20192783

Keywords:

Bacterial, Clinical, Pneumonia, Radiological, Risk factors, Viral

Abstract

Background: Pneumonia is one of the leading causes of morbidity and mortality in children under five years of age across the world. The present study was designed to clinically evaluate the children of age 1 month to 1 year with pneumonia, correlate it with bacteriological, radiological findings and to study the risk factors.

Methods: Clinical, bacteriological, radiological features and risk factors of community acquired pneumonia in children of age group 1 month to 1 year were noted and analysed.

Results: As per WHO ARI control programme, 72% had pneumonia, 25.3 % had severe pneumonia and 2.6% had very severe pneumonia. Bacterial pneumonia was detected radiologically in 4.6% and viral pneumonia in 88.6% of cases. Chest X-ray was normal in 6.6% of cases. Tachypnoea, chest retractions, crepitations alone and crepitations with rhonchi correlated well with positive radiological findings. Inappropriate immunization for age, lack of breast feeding, preterm birth, smoking in family were significant risk factors for severe Pneumonia. 39.3% had leucocytosis and 24% had positive CRP. Culture was positive in 23 cases (15.3% culture positivity).

Conclusions: Radiologically confirmed Pneumonia should be treated with antibiotics because, in clinical practice, it is virtually impossible to distinguish exclusively between viral pneumonia and bacterial pneumonia. As the viruses are most common causative agents of Pneumonia in 1 month to 1 year, PCR kits should be used to identify viral etiological agents. Early and exclusive breast feeding should be promoted to decrease the risk of pneumonia.

References

Mathew JL, Patwari AK, Gupta P, Shah D, Gera T, Gogia S, et al. Acute respiratory infection and Pneumonia in India: a systematic review of literature for advocacy and action: UNICEF-PHFI series on newborn and child health, India. Indian Pediatrics. 2011;1;48(3):191.

Rudan I, Pinto BC, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood Pneumonia. Bull World Heal Org. 2008;86:408-16B.

Smith KR. National burden of disease in India from indoor air pollution. Proceedings National Acad Sci. 2000; 21;97(24):13286-93.

World Health Organization. Technical bases for the WHO recommendations on the management of pneumonia in children at first-level health facilities. Geneva: WHO; 1991.

Park K. Environment and health. In: Park’s text book of preventive and social medicine, 22nd ed. Jabalapur: M/s Banarasidas Bhanot Publishers; 2013: 698.

Parthasarathy A. Nutrition. In: IAP Textbook of Paediatrics, 4th Ed. New Delhi; Jaypee medical publishers; 2009:143.

Park K. Medicine and social sciences. In: Park’s text book of preventive and social medicine, 22nd ed. Jabalapur: M/s Banarasidas Bhanot Publishers; 2013: 641.

Ghai OP, Paul VK, Bagga A, Pneumonia. Ghai Essential pediatrics 7th ed. Delhi; CBS publishers; 2009: P352-55.

Stanton K, Geme ST, Behrman S. Community acquired pneumonia. In: Nelson Textbook of Paediatrics. 19th ed. New Delhi; Elsevier; 2012: 1474-8.

Sehgal V, Sethi GR, Sachdev HP, Satyanarayana L. Predictors of mortality in subjects hospitalized with acute lower respiratory tract infections. Ind Pediatrics. 1997; 1;34(3):213-9.

Drummond P, Clark J, Wheeler J, Galloway A, Freeman R, Cant A. Community acquired pneumonia-a prospective UK study. Arch Dis Child 2000;83:408-12.

Kumar N, Singh N, Locham KK, Garg R, Sarwal D. Clinical evaluation of acute respiratory distress and chest wheezing in infants. Ind Pediatrics. 2002;39(5):478-83.

Margolis P, Gadomski A. Does this infant have pneumonia?. JAMA. 1998;28;279(4):308-13.

Palafox M, Guiscafré H, Reyes H, Muñoz O, Martínez H. Diagnostic value of tachypnoea in pneumonia defined radiologically. Arch Dis Childhood. 2000;82(1):41-5.

Gadomski AM, Aref GH, Hassanien F, Ghandour SE, El-mougi MA, Harrison LH, et al. Caretaker recognition of respiratory signs in children: correlation with physical examination findings, x-ray diagnosis and pulse oximetry. Inter J Epidemiol. 1993;22(6):1166-73.

Reddaiah VP, Kapoor SK. Acute respiratory infections in underfives: experience at comprehensive rural health services project hospital. Ballabgarh. Ind J Comm Med. 1995;20(2):13.

Virkki R, Juven T, Rikalainen H, Svedström E, Mertsola J, Ruuskanen O. Differentiation of bacterial and viral pneumonia in children. Thorax. 2002;57(5):438-41.

MacIntyre CR, McIntyre PB, Cagney M. Community-based estimates of incidence and risk factors for childhood pneumonia in Western Sydney. Epidemiol Infec. 2003;131(3):1091-6.

Zukin DD, Hoffman JR, Cleveland RH, Kushner DC, Herman TE. Correlation of pulmonary signs and symptoms with chest radiographs in the pediatric age group. Ann Emerg Mede. 1986;15(7):792-6.

Kabra SK, Lodha R, Broor S, Chaudhary R, Ghosh M, Maitreyi RS. Etiology of acute lower respiratory tract infection. Ind J Pedia. 2003;70(1):33-6.

Bahl R, Mishra S, Sharma D, Singhal A, Kumari S. A bacteriological study in hospitalized children with pneumonia. Ann Tropical Paediatrics. 1995;15(2):173-7.

Broor S, Pandey RM, Ghosh M, Maitreyi RS, Lodha R, Singhal T, et al. Risk factors for severe acute lower respiratory tract infection in under-five children. Ind Pedia. 2001;38(12):1361-9.

Hassan MA, Al-Sadoon I. Risk factors for severe pneumonia in children in Basrah. Tropical Doctor. 2001;31(3):139-41.

Ruuskanen O, Mertsola J. Childhood community-acquired pneumonia. InSeminars in respiratory infections 1999;14(2):163-72.

Korppi M, Kiekara O, Kosma HT, Soimakallio S. Comparison of radiological findings and microbial aetiol childhood Pneumonia. Acta Paediatrica. 1993;82(4):360-3.

Nohynek H, Valkeila E, Leinonen M, Eskola J. Erythrocyte sedimentation rate, white blood cell count and serum c-reactive protein in assessing etiologic diagnosis of acute lower respiratory infections in children. Pediatric Inf Dis J. 1995;14(6):484-90.

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Published

2019-06-27

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Original Research Articles