DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20194741

Simple predictors to differentiate acute respiratory infections from acute asthma in children 6 months to 5 years

Krithika Manikumar, Pooja Pradeep, R. Somasekar

Abstract


Background: Acute respiratory infections constitute one of the principal causes of morbidity and mortality in children less than five years of age in developing countries. For logistic reasons, WHO recommended case management is structured towards treatment as pneumonia in preference to acute asthma. It is warned that wheezing can occur during pneumonia and therefore, care must be taken when treating wheezing not to miss treating pneumonia with an antibiotic. Current WHO ARI CASE MANAGEMENT guidelines, in a child presenting with cough and rapid breathing, there is a predilection for over -treatment of pneumonia and under treatment of asthma.

Methods: Totally 245 children were included in the study. They were classified into asthmatic and LRI prone with the help of simple predictors.

Results: The combination of fever, chest indrawing and persistent tachypnoea after bronchodilator has an excellent specificity of 96.12% in predicting the presence of pulmonary infiltrate. The presence of more than two episodes of similar respiratory distress, previous H/O of nebulization and family H/O asthma, either alone or in combination may point more towards asthma as a cause of cough and respiratory distress.

Conclusions: In a child presenting with cough and fast breathing with a previous similar episode, trial nebulization can be given before investigating further for pneumonia.


Keywords


Antibiotics, Asthma, Bronchodilator, Pneumonia, Simple Predictors, WHO Criteria

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References


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