Pneumonia; frequency of under nutrition in children under 5 years of age

ABSTRACT

To find out an association between undernutrition and severity of pneumonia in children under five years of age. The study was carried out at paediatric department of Military Hospital Rawalpindi. From August 2003 to January 2004. Cross sectional analytical study. Children of either gender from 2 to 59 months of age with the clinical diagnosis of pneumonia made according to WHO guidelines were classified into various grades of nutritional status with referrence to the NCHS standards for weight for age. Five hundred children, including 280 [56%] boys and [220] 44% girls with the mean age 20.36 [ +/- 14.26] months were evaluated. One hundred and ninety five [39%] had pneumonia, 158 [31.6%] had severe pneumonia, whereas 147 [29.4%] had very severe pneumonia. Two hundred and eighty six [57.2%] children were normally nourished whereas 214 [42.8%] were undernourished; 133/214 [62.1%] had moderate and 81/214 [37.9%] had severe undernutrition. Fever [81%], cough [77%], nasal flaring [76%], tachypnoea and chest indrawing [61%] were the commonest presentations. The mean hospital stay was 6.9 [ +/- 2.65] days. Thirteen [2.6%] patients including 5 [38.5%] boys and 8 [61.5%] girls, who all were undernourished, expired. The relative risk of death in undernourished children was 1.065 times [95%CI= 1.029 to 1.102] that of normally nourished children [p<0.0001]. Younger age, severity of pneumonia and undernutrition are significant risk factors for morbidity, prolonged hospitalization and mortality in young children with pneumonia