Predisposing factors associated with longer hospital stay in children less than 5 years of age with severe lower respiratory tract infection

Objective: To determine the predisposing risk factors associated with longer duration of hospitalisation of children aged 2-59 months with severe Lower respiratory tract infection [LRTI]

Study Design: Observational / descriptive / cross sectional study

Place and Duration of Study: This study was carried out in the Children Hospital, Islamabad from October 2011 to March 2014

Materials and Methods: We enrolled 606 children aged 2-59 months with severe LRTI and at enrolment, complete history of present illness, physical examination, and necessary laboratory investigations were done. Enrolled children were managed according to the hospital's standard protocols. Multivariate logistic regression analyses was conducted to determine the independent factors associated with longer duration of hospitalisation

Results: The mean [sd] age of children was 7.45 [8.41] months and 63% were male. Of 606 children, 241 [40%] had longer hospital stay [>3 days].Children whose mothers used biomass energy as fuel for cooking at home [AOR 3.63, p<0.0001], children who had history of vomiting [AOR 1.74, p=0.014], had duration of illness before presenting to hospital was >7 days [AOR 1.90, p=0.040], were unvaccinated [AOR 2.54, p=0.001], had lower mean serum calcium levels [AOR 0.08, p<0.0001], had positive CRP [AOR 4.67, p<0.0001], were severely anaemic [AOR 6.28, p=0.017] or were underweight [AOR 1.64, p=0.013] had significantly longer hospitalisation compared to their counterparts

Conclusion: The current study identified independent risk factors which lead to longer hospitalisation in children aged 2-59 months with severe LRTI. Findings of the current study would help paediatricians for better management of severe LRTI in under 5 children

Clinical outcome in children hospitalized with complicated measles

To determine the association of clinical outcome of measles in children with demographic profile and complications. A cross-sectional analytical study. Isolation ward, The Children's Hospital, Pakistan Institute of Medical Sciences [PIMS], from January 2003 to August 2004. Detailed history and physical examination of all the hospitalized patients with complications of measles was filled in case report form. Immunization cards were assessed for measles vaccination status. Data was analyzed by using SPSS version 10 software. The clinical outcome of measles was compared with demographic profile and complications by using Chi-square test and p-values were obtained. Two hundred and five hospitalized patients with complications of measles were studied. There were 61.5% males. Mean age was 46.1 months and 57% patients were vaccinated against measles. Malnourished patients were 71.2% and had a longer hospital stay [p=0.010]. Pneumonia [40.0%] and diarrhoea [38.5%] were the commonest complications. Seven children died. Mortality was significantly associated with younger age [p=0.04], unvaccinated status [p=0.04] and presence of encephalitis [p=0.00001]. The most common complications of measles are pneumonia and diarrhoea with dehydration requiring hospitalization. Malnourished children experience more complications and have longer hospital stay. Mortality is significantly associated with infancy, unvaccinated status and encephalitis. A second dose of measles should be introduced at 15 months of age