Background. Lower respiratory tract infection (LRTI) is the main cause of pediatric mortality and morbidity in low- and middle-income countries. Purpose. This study was carried out to determine the clinical and epidemiological characteristics of children with LRTI. Method. A retrospective study was conducted on all pediatric patients who were hospitalized due to LRTI in Abuzar Hospital (Ahvaz, Iran) during one year. Incomplete medical records and children who were treated on an outpatient basis, as well as infants younger than 1 month of age, were excluded. The patients were evaluated in terms of epidemiological, clinical, and paraclinical characteristics. Results. A total of 303 hospitalized children and infants were identified. Their mean age was 29.09 ± 38.96 months (range 1 month-15 years), and 59.4% of them were males. The highest frequency of patients was at the age below one year (50.8%, n = 154 ). Pneumonia and bronchitis were the most common LRTIs. Respiratory (54.6%) and neurological (21.6%) diseases were the most prevalent underlying medical conditions. Admission was more common in winter ( n = 120 , 39.6%) and spring ( n = 79 , 26.1%). The mean length of stay (LOS) in the hospital was 8.2 ± 5.5 days, and the overall mortality rate was 11.6%. In addition, 65 patients were severely underweight and 271 patients were malnourished. Moreover, there was a significant association between mortality and disease diagnosis ( p < 0.05 ). Furthermore, there was a significant association between having an underlying disease and consanguineous parents ( p < 0.01 ), as well as the frequency of hospitalization ( p < 0.001 ). Conclusion. Additional studies are required to determine factors contributing to disease severity among children with LRTI to develop appropriate preventive and therapeutic strategies.

This study determined the level of immunity after MMR vaccination in 18 months and 6 years old children.Background: Mumps, measles and rubella viruses lead to various kinds of complications such as meningoencephalitis, deafness, congenital abnormalities and even cause mortality in malnourished patients,. Since 2004, MMR vaccination in two series of one year of age and four to six years has been administered to Iranian children as a part of routine vaccination program. Recently, MMR vaccination schedule has been changed to one year and 18 months series. Objectives: Since MMR vaccine has been recently entered childhood vaccination program, this study was performed to determine immunity response against mumps, measles and rubella six months after one year and four to six years of age vaccination. Patients and Methods:In a cross-sectional study, antibody titers after MMR vaccination at 18 months (six months after dose of one year) in 70 children, and at 6.5 years (six month after dose of six years) in 90 children referred to Ahvaz Abuzar Children's Hospital Vaccination Clinic during 2007-2008 were detected by ELISA method. Results: In 70 children (34 boys and 36 girls) who were vaccinated at one year, 30 (42.9 %) had antibody against measles, 63 (90 %) against rubella and 41 (58.6 %) against mumps. In 90 children (54 boys and 36 girls at 6.5 years of age (six months after vaccination), 41 (45.6%) children had antibody against measles, 79 (87.8 %) against rubella and 69 (76.7%) against mumps. Conclusions: the results of this study showed that after MMR vaccination, the level of antibody for measles was about 45 % and for mumps about 50-80 %. This level of immunity is not acceptable for successful vaccination. while the level of antibody against rubella was sufficient. For better evaluation of MMR vaccination, further studies and from other parts of the country is needed.

Background The objectives of this study were to analyze the clinical features and laboratory profiles and risk factors associated with critical illness of children with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Methods One hundred and sixty‐six coronavirus disease 2019 (COVID‐19) Iranian pediatric patients were recruited through a collaborative research network between March and May 2020. Demographics, clinical, laboratory, and radiological results were obtained from patient files. Results Of 166 patients, 102 (61%) and 64 (39%) were males and females, respectively. Ninety‐six (57.8%) and 70 (42.2%), had moderate and severe conditions, respectively. Thirty (18%) of patients died. The common symptoms were fever (73%), cough (54%), and shortness of breath, headache decrease in neutrophil and platelet counts; increase values in lactate dehydrogenase, decrease in the blood pH and HCO3 were significantly associated with the disease severity. 54% and 56% of patients showed abnormal radiographic appearance in Chest X‐ray and in chest computed tomography scan, respectively. Sixty‐one (36.7%) of patients were referred to intensive care unit (ICU). The coexistence of comorbidity was the main factor associated with ICU admission, shock, arrhythmia, acute kidney injury, acute respiratory distress syndrome, acute cardiac injury, and death. Conclusions We describe a higher than previously recognized rate of COVID‐19 mortality in Iranian pediatric patients. Epidemiological factors, such as the relatively high case fatality rate in the country and the presence of underlying diseases were the main factors for the high death rate.

Objective. In this study, by using clinical and paraclinical characteristics, we have aimed to predict the severity of the disease in hospitalized COVID-19 children. Method. This cross-sectional study was conducted on medical records about epidemiologic data, underlying diseases, symptoms, and laboratory tests from March to October, 2020, on 238 hospitalized confirmed COVID-19 paediatric cases in several children’s hospitals of Tehran, Ahwaz, Isfahan, and Bandar Abbas. Results. From 238 patients, 140 (59%) were male and most of them were in the age group of 1 to 5 years (34.6%). Among all hospitalized patients, 38% had an underlying disease and in total, 5% of cases were expired. Conclusion. Determining patient severity is essential for appropriate clinical decision making; our results showed that in hospitalized pediatric patients, by using several variables such as SGOT, CRP, ALC, LDH, WBC, O2sat, and ferritin, we can use clinical and paraclinical characteristics for predicting the severity of COVID-19.