DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20173775

Clinical study of lower respiratory tract infections in children attending a tertiary care hospital

Venkata Krishna Munagala, Ramisetty M. Uma Mahesh, Jithendra Kandati, Munilakshmi Ponugoti

Abstract


Background: WHO estimated burden of respiratory tract infections in 2010, estimates four and half million deaths due to respiratory tract infections among children every year. In India, 1.2 million deaths have been reported among children due to RTI among 5.9 million deaths globally. Lower respiratory tract infections are most common causes of death than upper respiratory tract infections. Pneumonia and Bronchiolitis are most common types of LRTI in children. Pneumonia accounts for most of the deaths in children < 5 years of age. The present study was undertaken with an objective to know the various types of lower respiratory tract infections in children less than 12 years of age. The study also aims to know the various bacterial agents causing respiratory tract infections with their antibiotic susceptibility.

Methods: Hospital based, prospective cross-sectional study was conducted for a period of one year and 375 children were enrolled. Demographic, clinical history and examination was done and signs and symptoms noted. All necessary investigations were performed and followed regularly for management and outcome.

Results: Incidence of LRTI in the study was 9.76% with male preponderance (65.33%) and most common among children in 1-4 years age group. Ratio of males to females was 1.9:1. 73.6% of cases were in low socio-economic group, 35.2% were found with PEM-I grade and 18.13% had no immunization coverage. Cough and breathlessness were the major symptoms and respiratory distress and clubbing were major signs in the study. Bronchopneumonia was the commonest cause (38.7%) followed by bronchiolitis and Allergic bronchitis. 18.45 of cases had anemia and Leucocytosis was also present. Pulmonary infiltration was the major finding in the X-ray of chest. Streptococcus pneumoniae and Klebsiella pneumoniae were the common bacterial pathogens isolated.

Conclusions: To conclude, our study clearly highlighted the various types of clinical presentations, risk factors and different types of LRTI in children <12 years of age. Understanding a clear knowledge of the etiology and bacterial pathogens clearly provides guidance for the physician in management and clinical outcome. 


Keywords


Allergic bronchitis, Broncho pneumonia, Klebsiella pneumoniae, LRTI, Streptococcus pneumoniae

Full Text:

PDF

References


WHO. World health organization pneumonia. 2012. Available from http://www.who.int/medicacentre/factsheets/en/.

Francis BV, Abhilash TG. Study of acute respiratory tract infections in children. Internat J Sci Res. 2016;5(9):1791-2.

Alter SJ, Vidwan NK, Sobande PO, Omoloja A, Bennett JS. Common childhood bacterial infections. Curr Probl Pediatr Adolesc Health Care. 2011;41(10):256-83.

Erling V, Jalil F, Hanson LA, Zaman S. The impact of climate on the prevalence of respiratory tract infection in early childhood in Lahore, Pakistan. J Pub Health. 1999;21:331-9.

Paramesh H. Epidemiology of asthma in India. Indian J Pediatr. 2002;69(4):309-12.

Yellanthoor RB, Shah VK. Prevalence of malnutrition among under-five year old children with acute lower respiratory tract infection hospitalized at Udupi District Hospital. Arch Pediatr Infect Dis. 2014;2(2):203-6.

Kabra SK, Broor S, Lodha R, Maitreyi RS, Ghosh M, Pandey RM, Puranik M. Can we identify acute severe viral lower respiratorytract infection clinically? Indian Pediatr. 2004;41(3):245-9.

Sonego M, Pellegrin MC, Becker G, Lazzerini M. Risk factors for mortality from acute lower respiratory infections (ALRI) in children under five years of age in low and middle-income countries: a systematic review and meta-analysis of observational studies. PloS one. 2015;10(1):e0116380.

Rashad MM, Fayed SM, El-Hag AM. Iron-deficiency anemia as a risk factor for pneumonia in children. Benha Medic J. 2015;32(2):96.

Mahajan V, Tiwari M, Arya A, Tiwari A, Chawla D, Saini SS. Clinical predictors of hospital admission in acute lower respiratory tract infection in 2 months to 2 year old children. Respirol. 2016;21(2):350-6.

Ranganathan SC, Sonappa S. Pneumonia and other respiratory infections. Pediatr Clin North Am. 2009;56(1):135-56.

Mansharamani NG, Koziel H. Chronic lung sepsis: lung abscess, bronchiectasis, and empyema. Curr Opin Pulmonary Med. 2003;9(3):181-5.

Ramakrishnan K, Harish PS. Hemoglobin level as a risk factor for lower respiratory tract infections. Indian J Pediatr. 2006;73(10):881-3.

Baranwal AK, Singh M, Marwaha RK, Kumar L. Empyema thoracis: a 10-year comparative review of hospitalised children from south Asia. Arch Dis Childhood. 2003;88(11):1009-14.

Joshi S, Lakhani JK. Clinical study and outcome of empyema thoracis in children in a district level hospital. Karnataka Pediatr J. 2004;18(1)2004:17.