Outcome of Acute Lower Respiratory Tract Infection in Children.

ABSTRACT

Objective: To identify the outcome of acute lower respiratory tract infection (ALRTI) and factors contributing in mortality. Design: Prospective cohort study. Setting: Urban tertiary care teaching hospital. Methods: 100 cases with ALRTI between 2 weeks to 5 years of age were prospectively enrolled and followed up to determine outcome. Detailed history and clinical evaluation were recorded on a pre-tested proforma.Outcome and significant independent factors contributing to mortality were determined by comparison of dead subjects (n=10) with surviving children (n=90) in a multiple logistic analytic framework. Results: The case fatality rate (CFR) was 10%. The significant (p <0.05) independent factors contributing to mortality were pallor (OR 10.7), age less than 1 year (OR 9.4), inability to feed (OR 9.3), weight for age Z score (WAZ) <-3 (OR 6.6), presence of loose stools (OR 5.3), Hb<10(OR 1.6). The CFR was related to severity of WHO classification (“pneumonia”-0%, “severe pneumonia”-8.7% and “very severe pneumonia”-47.0%). Factors contributing to prolonged hospital stay included lack of exclusive breastfeeding [OR (95%CI)-4.37(1.69-11.28) RR (2.04)] and fever [OR (95%CI)-5.59(1.92-16.2) RR (2.3)] on multivariate analysis. Conclusion: ALRTI in children is a major concern. Presence of factors like pallor, age below 1 year, inability to feed, presence of loose stools and severe malnutrition require urgent intervention.