Risk Factors and Outcome of Respiratory Disease in Children Aged between 2 Months to 5 Years: A Prospective Observational Study

Abstract

Introduction: Acute Respiratory Infection (ARI) constitutes a leading cause of morbidity and mortality in children. It is one of the major causes of under-five mortality in the world and in India. India is improving its position in ranking following the recent measures it has made toward improving access to child health interventions like Haemophilus influenzae type b (Hib) and pneumococcal vaccination, promoting exclusive breast feeding as well as strengthening critical care services to protect children from severe disease Aim: To assess the risk factors associated with respiratory disease and detect mortality and morbidity among children between the age of 2 months to 5 years. Materials and Methods: The study was conducted in the Department of Paediatrics, SCB Medical and Hospital, Cuttack, Odisha, India. A total of 306 cases of acute respiratory diseases between the age group of 2 months to 5 years admitted during the period from September 2018 to September 2019 were enrolled. After detailed history and examination, the risk factors were compiled. Morbidity was assessed in the form of need for ventilation, prolonged Paediatric Intensive Care Unit (PICU) stay and hospital stay. Chi-square test for categorical data and Kruskal-Wallis test for non parametric data was used to identify whether various risk factors for morbidity and mortality of ARI cases were statistically significant. Results: Out of 2793 children between 2 months to 5 years of age, 306 (10.95%) had ARI. Of these, 288 (94.12%) children survived and 18 (5.88%) died. Most of them were males 186 (60.78%) but mortality was more among females, 10 (8.33%) Children who were not exclusively breastfed were 173 (56.54%) and who were from low socio-economic class (24,79.41%), inadequately immunised were 191 (62.4%), or had bad child rearing practices were 175 (57.2%), had higher risk of ARI were 12 (66.67%) and mortality 18 (100%) was also higher in this group. Sepsis 18 (100%), malnutrition 14 (77.78%) and need for mechanical ventilation 18 (100%) were significant risk factors for mortality. Conclusion: Low socio-economic status, malnourishment and lack of exclusive breastfed for 1st six months of age have significant bearing on the occurrence of ARI. Children between 2-12 months are most vulnerable. Very severe pneumonia and bronchiolitis had a poor outcome.

Keywords

• acute respiratory infection
• mortality
• pneumonia
• undernutrition