Clinical profile of children aged 2 months to 60 months presenting with wheeze in a tertiary medical centre
Keywords:Allergy, Artificial breast feeding, Malnutrition, Pneumonia, Wheezing
Background: Wheezing is common throughout infancy and childhood except in the neonatal period where it is relatively rare. By 10 years of age, about 19% of children experience wheezing with an average onset at 3 years of age. This study was aimed to identify the diverse factors associated with wheezing in children aged 2 months to 60 months and to study clinical profile along with short term outcome of the same.
Methods: It was a hospital based cross-sectional study carried out in the Department of Paediatrics, Regional Institute of Medical Sciences Hospital (RIMS), Imphal, Manipur. The Study population consisted of randomly selected 131 children aged 2 months to 60 months who were admitted in Paediatrics ward with the symptom of wheezing.
Results: Authors found that age below 12 months, male sex, low socioeconomic conditions and artificial breastfeeding practices were important risk factors for wheeze.
Conclusions: Wheezing is accountable for a high demand of medical consultations and emergency care services with relatively high rates of hospitalization. Along with ARI, it plays an important role in infant mortality. In Manipur, it is being observed that increasing number of children with wheezing are attended by paediatricians in ED, OPD and ward, thereby proving an added burden to the younger age group. Therefore proper health education and counselling of parents, promotion of exclusive breast feeding and improvement of socioeconomic status can play a vital role in preventing occurrence of wheeze among the children.
Coates BM, Camarda LE, Goodman DM. Wheezing, Bronchiolitis and Bronchitis. In: Kliegman RM, Stanton BF, St Game JW, Schor NF, Behrman RE, editors. Nelson Textbook of Paediatrics. 20th ed. Philadelphia: Elsevier Saunders; 2016:2044-2049.
Park K. Acute Respiratory Infections. In: Park K, editors. Text book of preventive and social medicine. 21st ed. India: Bhanot; 2011:157-167.
Lavanya KB, Vasundhara TL, Pasha SZ, Veeramanil G, Chidambaranathan S. Comparison of effect of nebulisation with different combination of medications in paediatrics patients with WALRI. World J Pharmacy Pharmaceutical Sci. 2014;3(8):669-79.
Bada C, Carreazo NY, Chalco JP, Huicho L. Inter-observer agreement in interpreting chest X-rays on children with acute lower respiratory tract infections and concurrent wheezing. Sao Paulo Med J. 2007;125(3):150-4.
Shay DK, Holman RC, Newman RD, Liu LL, Stout JW, Anderson LJ. Bronchiolitis associated hospitalizations among US children. J o Am Med Asso. 1999;282(15):1440-6.
Broor S, Pandey RM, Ghosh M, Maitheyi RS, Lodha R, Singhal T, et al. Risk factors for severe acute lower respiratory tract infection in under five children. Indian Pediatr. 2001;38(12):1361-9.
Mallol J, Andrade R, Auger F, Rodriguez J, Alvarado R, Figueroa L. Wheezing during the first year of life in infants from low-income population. Allergol Immunopathol. 2005;33(5):257-63.
Savitha MR, Nandeswara SB, Pradeepkumar MJ, Haque F, Raju CK. Modifiable risk fctors for acute lower respiratory tract infection. Indian J Pediatr. 2007;74(5):477-82.
Azad K. Risk factors of acute respiratory infection among children under 5 years in Bangladesh. J Sci Res. 2009;1(1):72-81.
Patra S, Singh V, Kumar P, Chandra J, Dutta A, Tripathi M. Demographic and clinical profile of children under two years of age with recurrent wheezing. J Coll Physicians Surg Pak. 2011;21(11):715-7.
Kwon JE, Yoon JH, Lee JO, Kang IJ. A clinical study on wheezing of Mycoplasma pneumoniae pneumonia in children. Korean J Pediatr. 1993;36(10):1366-74.
Sherriffa A, Petersb TJ, Hendersonc J, Strachand D. Risk factor associations with wheezing patterns in children followed longitudinally from birth to 3 ½ years. Int J Epidemiol. 2001;30(6):1473-84.
Mandhane PJ, Greene JM, Cowan JO, Taylor DR, Sears MR. Sex differences in factors associated with childhood and adolescent onset wheeze. Am J RespirCrit Care Med. 2005;172(1):45-54.
Marcos L, Mallol J, Sole D, Brand PLP. International study of wheezing in infants risk factors in affluent and non-affluent countries during the first year of life. Pediatr Allergy Immunol. 2010;21(5):878-88.
Bessa OA, Leita AJ, Sole D, Mallol J. Prevalence and risk factors associated with wheezing in the first year of life. J Pediatr. 2014;90(2):190-6.
Prajapati B, Talsania N, Sonaliya KN. Epidemiological profile of acute respiratory tract infections in under five age group of children in urban and rural communities of Ahmedabad District, Gujarat. Int J Med Sci Public Health. 2011;1(2):52-8.
Tariq S, Hakim E, Matthews S, Arshad S. Influence of smoking on asthmatic symptoms and allergen sensitisation in early childhood. Postgrad Med J 2000;76(901):694-9.
Hermann C, Westergaard T, Pedersen BV, Wohlfahrt J, Host J, Melbye M. A comparison of risk factors for wheeze and recurrent cough in preschool children. Am J Epidemiol 2005;162(4):345-50.
Goksor E, Amark M, Alm B, Gustafsson PM, Wennergren G. The impact of pre- and post-natal smoke exposure on future asthma and bronchial hyper-responsiveness. Acta Paediatr. 2007;96(7):1030-5.