Prevalence, Predictive Factors, and Outcomes of Respiratory Failure in Children With Pneumonia Admitted in a Developing Country (original) (raw)
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Mortality predictors of pneumonia in children
Paediatrica Indonesiana, 2010
Background Pneumonia is one of the main causes of death in children in developing countries. It is important to identify clinical signs, demographic factors, and laboratory data which can be used to predict children who have higher risk of mortality from pneumonia.Objective To find the clinical signs, demographic factors and laboratory data that can be used as predictors of mortality from pneumonia.Methods T his historical casecontrol study was carried out in Sardjito Hospital between January 2004 and December 2006. Data were obtained from medical records. Differential proportion between groups was analyzed with chi square. Regression analysis was used to identify clinical factors, demographic factors and laboratory factors that associated with mortality from pneumonia.Results Fiftyeight patients were enrolled in this study, 29 patients were dead (case group) and 29 patients were cured (control group). Baseline data between the two groups were similar in terms of gender and mean o...
BMC Medicine
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Indian Journal of Child Health, 2017
neumonia is a leading cause of morbidity and mortality in under-five children. According to the recent WHO estimate, pneumonia is responsible for 15% of deaths in the under-fives, killing 9,20,136 children in 2015. Nearly 23% of the total under-fives' death and 20-30% of under-fives' admissions in India are due to pneumonia. According to hospital-based studies, case fatality rate (CFR) was reported to vary between 8.7% and 47% [1-4]. Both community as well as hospital-based studies have highlighted a variety of factors contributing to mortality in childhood pneumonia [3-8]. With socioeconomic progress and improvement in health awareness and referral services, an increasing proportion of pneumonia deaths will occur in hospitals [9]. It is presumed that positive chest X-ray findings are mainly due to the bacterial pneumonia which needs to be treated with antibiotics; hence, we planned to evaluate the risk factors associated with outcome in radiologically proven pneumonia and to compare it with that of the WHO-defined severe and very severe pneumonia. There are only a few studies on other relevant outcomes including the need for change of antibiotics, prolonged hospital stay (i.e., more than 5 days), and need for mechanical ventilation. These factors need to be evaluated so that we can predict the outcome early during illness and can take interventions accordingly. We planned this study to identify these factors and other relevant outcomes so that we can modify the course of illness. MATERIALS AND METHODS This is a hospital-based study over a period of 18 months from November 2013 to March 2015 conducted in pediatrics ward of a tertiary care hospital. The study was conducted after obtaining Institutional Ethics Committee's approval, and patients were enrolled after receiving written consent of the parents/legally acceptable representatives. A total of 300 children of either sex between 2 and 59 months of age with the WHO-defined severe and very severe pneumonia were enrolled in the study [10]. Children having other comorbid conditions such as severe malnutrition, congenital malformations, congenital heart disease, meningitis, severe anemia (hemoglobin <7 gm% or as per the ABSTRACT Objective: The objective of this study was to determine the factors associated with outcome (morbidity and mortality) in children aged 2-59 months with severe and very severe pneumonia. Materials and Methods: This is a hospital-based, prospective, observational study conducted in the pediatric department of a tertiary care hospital. Totally 300 children of either sex between 2 and 59 months of age with the WHO-defined severe pneumonia and very severe pneumonia were enrolled in the study. Associations of outcomes and various clinical symptoms were assessed using Chi-square test first and then through logistic regression models. Results: In our study, 86 (28.7%) children stayed in hospital more than 5 days, 113 (37.7%) needed change in antibiotics, 24 (8%) developed complications (5% effusion and 3% pneumothorax), and 31 (10.3%) expired. Multivariate analysis showed that younger age at presentation, household pollution (cooking fuel other than liquefied petroleum gas), and children who did not receive exclusive breastfeeding were prone to develop more severe pneumonia. Head nodding and cyanosis were independent factors significantly associated with mortality on multiple logistic regression. Radiologically proven pneumonia cases required change in antibiotics more frequently and stayed for longer duration in hospital as compared to clinical pneumonia cases. Conclusions: Children with signs of severe respiratory distress such as head nodding, cyanosis and altered sensorium, anemia, decreased or increased total leukocyte count, and hypoxemia have greater risk of mortality. Children with risk factors including overcrowding, indoor air pollution, lack of exclusive breastfeeding and proper immunization, and abnormal chest radiograph are less likely to respond to the first-line antibiotics; therefore, they may be treated aggressively with the second-line antibiotics from the beginning so that their hospital stay may be reduced.
The Southeast Asian journal of tropical medicine and public health, 2008
We compared the socio-demographic and clinical outcomes as predictors in severely ill hospitalized under-five diarrheal children with and without pneumonia. We studied 496 under-five children with diarrhea admitted to the Special Care Ward (SCW) of Dhaka Hospital of International Center for Diarrheal Disease Research, Bangladesh from 1999 to 2004. Children with pneumonia, in addition to their diarrhea, constituted the study group (cases), and those who did not have pneumonia constituted the comparison (control) group. The individual predictors of pneumonia in children were a history of cough (OR 2.19, 95% CI 1.30-3.72, p=0.002), fever (OR 1.73, 95% CI 1.19-2.53, p=0.003), and rapid breathing (OR 2.45, 95% CI 1.49-4.03, p<0.001). Hypothermia (6% vs 2%; p=0.02), hyponatremia (41% vs 27%; p=0.003) and dehydrating diarrhea (81% vs 69%, p=0.003) were more frequent in control children. On logistic regression analyses, the case fatality among children with pneumonia was nearly two times...
BMJ Open
ObjectivePneumonia remains the leading cause of hospitalisations and deaths among children aged <5 years. Diverse respiratory pathogens cause acute respiratory infections, including pneumonia. Here, we analysed viral and bacterial pathogens and risk factors associated with death of hospitalised children.DesignA 9-year case series study.SettingTwo secondary-care hospitals, one tertiary-care hospital and one research centre in the Philippines.Participants5054 children aged <5 years hospitalised with severe pneumonia.MethodsNasopharyngeal swabs for virus identification, and venous blood samples for bacterial culture were collected. Demographic, clinical data and laboratory findings were collected at admission time. Logistic regression analyses were performed to identify the factors associated with death.ResultsOf the enrolled patients, 57% (2876/5054) were males. The case fatality rate was 4.7% (238/5054), showing a decreasing trend during the study period (p<0.001). 55.0% of ...