Acute illness observational scale in community acquired pneumonia in tertiary care unit in age group of 2 months to 5 years
DOI:
https://doi.org/10.18203/2349-3291.ijcp20250410Keywords:
AIOS score, Clinical severity assessment, Community-acquired pneumonia, Pediatric respiratory illness, Treatment outcome predictionAbstract
Background: Community-acquired pneumonia (CAP) remains the leading cause of under-five mortality in India. The Acute Illness Observation Score (AIOS), developed by P. L. McCarthy, offers a systematic approach to assess illness severity based on six observable factors in pediatric patients.
Methods: A prospective, cross-sectional study conducted at a Department of Paediatrics, Guru Gobindsingh Government Hospital and Shri M P Shah Government Hospital, Jamnagar and enrolled 210 children aged 2-59 months with CAP. After obtaining institutional ethical clearance and parental consent, patients were assessed using AIOS criteria at admission and day 5, monitoring clinical outcomes and treatment responses.
Results: Children with abnormal AIOS scores (>10) at admission showed significantly higher rates of tachypnea (p:0.001), severe respiratory distress (p<0.001), and feeding difficulties. Among severe pneumonia cases, 56.7% required oxygen support and advanced antibiotics. Breastfeeding and complete immunization emerged as protective factors. Comparison between admission and day 5 AIOS scores demonstrated significant improvement with treatment.
Conclusions: AIOS proves to be a reliable and effective tool for evaluating CAP severity in pediatric patients. Strong correlations between AIOS scores and clinical outcomes validate its utility in guiding treatment decisions and predicting prognosis, particularly in resource-limited settings, making it a valuable adjunct to clinical judgment.
Metrics
References
Armon K. Audit: determining the common medical presenting problems to an accident and emergency department. Arch Dis Childhood. 2001;84(5):390-2. DOI: https://doi.org/10.1136/adc.84.5.390
World Health Organization. Pneumonia, 2019. Available at: https://www.who.int/news-room/fact-sheets/detail/pneumonia. Accessed 01 December 2024.
McCarthy P, Sharpe M, Spiesel S, Dolan T, Forsyth B, DeWitt T, et al. Observation scales to identify serious illness in febrile children. Pediatrics 1982;70(5):802-9. DOI: https://doi.org/10.1542/peds.70.5.802
Cao Y, Zhao L, Miao H. Risk factors for progression to severe pneumonia in children visiting the emergency department with pneumonia. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2023;35(5):528-32.
Sanikam H, Kenganal RB, Basavaraj, Mavinahalli A. Clinical and socio-demographic profile of pneumonia in children aged 2 months to 5 years. Pana J Medi Sci. 2024;14(1):204-9. DOI: https://doi.org/10.18231/j.pjms.2024.037
Ferdous F, Ahmed S, Das S, Chisti M, Nasrin D, Kotloff K, et al. Pneumonia mortality and healthcare utilization in young children in rural bangladesh: a prospective verbal autopsy study. Tropi Medi Health. 2018;46(1). DOI: https://doi.org/10.1186/s41182-018-0099-4
Solomon Y, Kofole Z, Fantaye T, Ejigu S. Prevalence of pneumonia and its determinant factors among under-five children in Gamo Zone, southern Ethiopia, 2021. Front Pediatr. 2022;10:1017386. DOI: https://doi.org/10.3389/fped.2022.1017386
Yallew WW, Assefa S, Yemane B. Pneumonia among under–five children in Ethiopia: a retrospective analysis from an urban hospital. Research Square. 2023. DOI: https://doi.org/10.21203/rs.3.rs-2790057/v1
Al Janabi MK. Pneumonia in children admitted with lower respiratory tract infections… A hospital based study. J Facul Medi Baghdad. 2012;54(4):294-9. DOI: https://doi.org/10.32007/jfacmedbagdad.544711
Fadl N, Ashour A, Yousry Muhammad Y. Pneumonia among under-five children in Alexandria, Egypt: a case-control study. J Egypt Pub Heal Associa. 202095:1-7.
de-Miguel-Díez J, López-de-Andrés A, Hernández-Barrera V, deMiguel-Yanes JM, Carabantes-Alarcón D, Ji Z, et al. Sex-differences in incidence of hospitalizations and in hospital mortality of community-acquired pneumonia among children in Spain: a population-based study. Eur J Pediatr 2022;181(7):2705-13. DOI: https://doi.org/10.1007/s00431-022-04478-9
Kifle M, Yadeta T, Debella A, Mussa I. Determinants of pneumonia among under-five children at hiwot fana specialized hospital, eastern ethiopia: unmatched case-control study. BMC Pulm Medi. 2023;23(1). DOI: https://doi.org/10.1186/s12890-023-02593-3
Roselany R, Surjono E. Pneumonia Clinical Features in Under-Five Children Treated in Atma Jaya Hospital in 2017-2020. Majalah Kedokteran Bandung. 2023;55(1):21-6. DOI: https://doi.org/10.15395/mkb.v55n1.2966
Kehinde Adebola Atoloye, Temitayo Victor Lawal, Ayo Stephen Adebowale et al. A spatio-temporal mapping and bayesian modelling of fever, cough and short rapid breaths, as symptoms of pneumonia in under-five children in Nigeria. Res Squ. 2023:1-29. DOI: https://doi.org/10.21203/rs.3.rs-3011320/v1
Ekyaruhanga P, Nantanda R, Aanyu H, Mukisa J, Ssemasaazi J, John M, et al. Delay in healthcare seeking for young children with severe pneumonia at mulago national referral hospital, Uganda: a mixed methods cross-sectional study. Plos One. 2023;18(10):e0291387. DOI: https://doi.org/10.1371/journal.pone.0291387
Dinka IR, Seyoum D, Debelo S, Fikadu G, Regasa MT, Abdena HF, et al. Time to recovery and its predictors among under-five children admitted with severe pneumonia in East Wallaga Zone public hospitals, western Ethiopia, 2023; a retrospective cohort study. BMC Pediatr. 2024;24(1):1-12. DOI: https://doi.org/10.1186/s12887-024-04937-2
Pareek S. Exclusive breastfeeding in India: an ultimate need of infants. Nurs Pract Today. 2019;6(1):4-6. DOI: https://doi.org/10.18502/npt.v6i1.387
Watkins C, Leeder S, Corkhill R. The relationship between breast and bottle feeding and respiratory illness in the first year of life. J Epidemiol Amp Commu Health. 1979;33(3):180-2. DOI: https://doi.org/10.1136/jech.33.3.180
Lamberti L, Zakarija‐Grković I, Walker C, Τheodoratou E, Nair H, Campbell H, et al. 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(S3). DOI: https://doi.org/10.1186/1471-2458-13-S3-S18
Metkie K, Melese G, W/silassie B, Ali F. Determinants of immunization status among 12–24 months old children in ethiopia: using 2019 ethiopian mini demographic and health survey data. Plos One. 2023;18(3):e0283629. DOI: https://doi.org/10.1371/journal.pone.0283629
Gavi The Vaccine Alliance. Pneumococcal vaccine support. Available at: https://www.gavi.org/types-support/vaccine-support/pneumococcal. Accessed 01 December 2024.
UNICEF. Pneumonia in children: Everything you need to know. Available at: https://www.unicef.org/stories/childhood-pneumonia-explained. Accessed 01 December 2024.
Barrow A, Afape AO, Cham D, Azubuike PC. Uptake and determinants of childhood vaccination status among children aged 0-12 months in three West African countries. BMC Publ Health. 2023;23(1):1-12. DOI: https://doi.org/10.1186/s12889-023-15863-w
Kumar N, Allyhan P, Aggarwal A. Effect of Covid pandemic on immunization status of children in tertiary care Hospital of North India: reason for partial and non-immunization a cross-sectional study. J Health Popul Nutr. 2024;43(1):1-7. DOI: https://doi.org/10.1186/s41043-023-00494-z
Bharti B, Bharti S, Verma V. Role of acute illness observation scale (AIOS) in managing severe childhood pneumonia. Ind J Pediatr. 2007;74(1):27-32. DOI: https://doi.org/10.1007/s12098-007-0022-1
Spuesens EB, Fraaij PL, Visser EG, Hoogenboezem T, Hop WC, van Adrichem LN, et al. Carriage of Mycoplasma pneumoniae in the upper respiratory tract of symptomatic and asymptomatic children: an observational study. PLoS Med. 2013;10(5):e1001444. DOI: https://doi.org/10.1371/journal.pmed.1001444
Anoop K. Acute Illness Observation Scale in community acquired pneumonia in children aged 2 months to 59 months. Int J Contemp Pediatrics. 2020;7(6):1394. DOI: https://doi.org/10.18203/2349-3291.ijcp20202154
Ferrer M, Travierso C, Cilloniz C, Gabarrus A, Ranzani OT, Polverino E, et al. Severe community-acquired pneumonia: Characteristics and prognostic factors in ventilated and nonventilated patients. PLoS One. 2018;13(1):e0191721. DOI: https://doi.org/10.1371/journal.pone.0191721
Downloads
Published
How to Cite
Issue
Section
