Etiological factors and clinical profile of acute respiratory distress in children age group 2 months to 2 years and prevalence of respiratory syncytial virus in the study population


  • A. Logesh Anand Department of Paediatrics, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu, India
  • S. Vijayaraghavan Department of Paediatrics, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu, India



Acute respiratory distress, Hyperthermia, IgM, Malnutrition, Pneumonia, Viral infection


Background: Acute lower respiratory tract infections are a common cause of morbidity and mortality in children. Respiratory infections in infants and small children are of great importance because of small airways. Infection may cause a further narrowing and may lead to respiratory distress. To evaluate the etiological factors, clinical profile and outcome of acute respiratory distress in the age group 2 months to 2 years.

Methods: This study was conducted in the Paediatric department of Government Mohan Kumarmangalam medical college hospital, Salem, Tamil Nadu, India in the year September 2017-March 2018. Totally 183 cases of acute respiratory distress children were included in the study. A thorough clinical examination was done at the time of admission and management details were recorded into the proforma. Respiratory distress is defined as per WHO protocol as respiratory rate more than 50/minute in infants from 2 months to 12 months of age, and more than 40/minute in children from 13 months to 24 months of age.

Results: Of the 72 cases of bronchiolitis, 32 cases (44%) tested positive for IgM at the time of admission and no cases in the control population tested positive for IgM. Of the 72 cases of bronchiolitis in the study population, 52 cases (72%) tested positive for ELISA IgG at the time of admission and 2 cases among the controls tested positive for ELISA IgG.

Conclusions: Pneumonia was the most common cause of respiratory illness in the study population. Overcrowding was the major risk factor contributing to acute respiratory illness. Incidence of acute respiratory distress was high among undernourished children.


C Antonio Pio. WHO Programme on acute respiratory infections. Indian J Pediatr. 1988;55:197-205.

Broor S, Pandey RM, Ghosh M, et al. Risk factors for severe acute lower respiratory tract infection in under five children, Indian Pediatr. 2001 Dec;38(12):1361-9.

Cherian T. Simoes EA, Steinhoff, Chitra K, John M, Raghupathy John TJ, Bronchiolitis in tropical South India AM. J Dis child. 1990 Sep;144(9):1026-30.

Deivanayagam N. Neduchezian K, Ramaswamy S, Kannan S, Ratnam SR. Risk Factors for fatal Pneumonia, A case-control study. Indian Pediatr. 1992;29:1529-32.

Ekalaksananan T, Pientonge, Ingyoes KB, Pairojkuls, Sara TJ, Hangs, Etiology of acute lower respiratory tract infection in children at the srinagarind hospital, Khonkaen, Thailand, Southeast Asian J Trop Med Public Health. 2001Sep;32(3):513-9.

Fonseca W, Kirkwood BR, Victora CG, Fuchs SR, Flores JA, Misago C. Risk factors for childhood pneumonia among the urban poor in Fortaleza, Brazil: a case-control study. Bulletin World Health Organization. 1996;74(2):199-208.

Garcia MG, Calvo CR, Quevedo ST, Martínez MP, Sánchez FO, del Valle Martín F, et al. Chest radiograph in bronchiolitis: is it always necessary?. In Anales de Pediatria (Barcelona, Spain: 2003). 2004 Sep;61(3):219-25.

Garenne M, Ronsmans C, Campbell H. The magnitude of mortality from acute respiratory infections in children under 5 years in developing countries. World health statistics quarterly. 1992;45:180.

Henderson FW, Clyde WA, Collier Am. The etiologic and epidemiologic spectrum of bronchiolitis in pediatric practice. J Pediatr. 1979;95(2):183-90.

Hussey GD, Apollos P. RSV infection in children hospitalized with acute lower respiratory tract infection SAFR med. 2000 May 90(5):509-12.

John TJ, Cherian T, Steinhoff MC, Simoes EA, John M. Etiology of Acute lower respiratory infection in children in tropical south India. Reviews Infectious Diseases. 1991 May-Jun;13(16):5463-9.

Lippmann M. Effects of respiratory function and structure. Ann Rev Public Health. 1989;10:49-67.

Morrow PW. Toxicological data on NO: An overview. J Toxicol Environ Health. 1984;13:205-27.

Peter D. Phelan epidemiology of ARI.IN respiratory ilness in children. J Clin Research Peadtri. 1991;19:304-7.

Raddaiah VP, Kapoor SK. Epidemiology of ARI. In respiratory illnesses in children. 1990;57:707-4.

Rattana Dilok Na, Bhuke T, Sunakora P, Suwanjutha S, Kawano Partake S, Teeya Paidoonsilpa P. Wheezing associated lower respiratory infections in under 5 years. Old children: Study in Takhli District hospital. J Med Assoc Thai. 2002 Nov;85(4):S1247-51.

Reddaiah VP, Kapoor SK. Management of ARI for control of mortality in under-fives. Indians J Pediatr. 1993;60:283-8.

Smith KR, Sarnet JM, Romieu I, Bruce N. Indoor air pollution in developing countries and acute lower respiratory infection in children. Thorax 2000;55:518-32.

Smyth A, Ridwan R, Cairns S. Impact of case management protocol for childhood pneumonia in a rural Zambian hospital. Ann Trop Pediatr. 1997;17:321-6.

Brandenburg AH, Jeannet PY, Sleensell Moll, Henriette Av. Local variability in Respiratory syncytial virus Disease severity. Arch dis child. 1997;77:414.

Respiratory infections: Diagnosis and management. Second edition by James E. Penington. 1988;81:345-51.






Original Research Articles