Clinical and Epidemiological Determinants of Lower Respiratory Tract Infections in Hospitalized Pediatric Patients

Mirkarimi, Mohammadreza; Alisamir, Mohsen; Saraf, Salar; Heidari, Solmaz; Barouti, Shahriar; Mohammadi, Shooka

doi:10.1155/2020/8844420

Cited by 10 publications

(17 citation statements)

References 36 publications

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“…The case-fatality ratios due to severe ALRI in admitted children younger than 5 years were estimated to be 2.3% (1.6–3.4%) in developing countries and 0.6% (0.4–0.8%) in developed countries [ 45 ], with an exception in eastern Mediterranean countries (7.6%; 4.9–7.9%) [ 45 ]. The factors affecting mortality were also investigated, including underlying neurological diseases [ 46 ], high rates of severe stunting (21%) [ 46 ], or insufficient data [ 45 , 47 ]. In the current study, the rate of stunting was high (25%), though it did not differ significantly between fatal and non-fatal cases.…”

Section: Discussionmentioning

confidence: 99%

Clinical manifestations and outcome of viral acute lower respiratory infection in hospitalised children in Myanmar

Kamata

Thein

et al. 2022

BMC Infect Dis

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Background Acute lower respiratory infection (ALRI) remains the leading cause of death in children worldwide, and viruses have been the major cause of ALRI. In Myanmar, ALRI is associated with high morbidity and mortality in children, and detailed information on ALRI is currently lacking. Methods This prospective study investigated the viral aetiologies, clinical manifestations, and outcomes of ALRI in hospitalised children aged 1 month to 12 years at the Yankin Children Hospital, Yangon, Myanmar from May 2017 to April 2019. The sample size was set to 300 patients for each year. Two nasopharyngeal swabs were obtained for the patients with suspected viral ALRI; one for rapid tests for influenza and respiratory syncytial virus (RSV), and the other for real-time PCR for the 16 ALRI-causing viruses. Pneumococcal colonization rates were also investigated using real-time PCR. Clinical information was extracted from the medical records, and enrolled patients were categorised by age and severity for comparison. Results Among the 5463 patients admitted with a diagnosis of ALRI, 570 (10.4%) were enrolled in this study. The median age of the patients was 8 months (interquartile range, 4–15 months). The most common symptoms were cough (93%) and difficulty in breathing (73%), while the most common signs of ALRI were tachypnoea (78%) and chest indrawing (67%). A total of 16 viruses were detected in 502 of 570 patients’ samples (88%), with RSV B (36%) and rhinovirus (28%) being the most commonly detected. Multiple viruses were detected in 221 of 570 samples (37%) collected from 570 patients. Severe ALRI was diagnosed in 107 of 570 patients (19%), and RSV B and human rhinovirus were commonly detected. The mortality rate was 5%; influenza virus A (29%) and RSV B (21%) were commonly detected, and stunting and lack of immunization were frequently observed in such cases. Additionally, 45% (259/570) of the patients had pneumococcal colonization. Conclusions Viral ALRI in hospitalised children with a median of 8 months has significant morbidity and mortality rates in Myanmar. RSV and rhinovirus were the most commonly detected from nasopharyngeal swabs, while influenza virus and RSV were the most frequently associated with fatal cases.

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Section: Discussionmentioning

confidence: 99%

Clinical manifestations and outcome of viral acute lower respiratory infection in hospitalised children in Myanmar

Kamata

Thein

et al. 2022

BMC Infect Dis

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“…The case-fatality ratios due to severe ALRI in admitted children younger than 5 years were estimated to be 2.3% (1.6-3.4%) in developing countries and 0.6% (0.4-0.8%) in developed countries (40), with an exception in eastern Mediterranean countries (7.6%; 4.9 %-7.9%) (40). The factors affecting mortality were also investigated, including underlying neurological diseases (41), high rates of severe stunting (21%) (41), or insu cient data (40,42). In the current study, the rate of stunting was high (25%), though it did not differ signi cantly between fatal and non-fatal cases.…”

Section: Discussionmentioning

confidence: 99%

Title: Clinical Manifestations and Outcome of Viral Acute Lower Respiratory Infection in Hospitalised Children in Myanmar

Kamata¹,

Thein²,

Ja³

et al. 2021

Preprint

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Background Acute lower respiratory infection (ALRI) remains the leading cause of death in children worldwide, and viruses have been the major causative factors of ALRI after the introduction of bacterial conjugate vaccines. In Myanmar, ALRI is associated with high morbidity and mortality in children. However, detailed information on ALRI is currently lacking. Methods We conducted a prospective study to investigate the viral aetiologies, clinical manifestations, and outcomes of ALRI in hospitalised children at the Yankin Children Hospital, Yangon, Myanmar from May 2017 to April 2019. The World Health Organization’s definitions of ALRI and severe ALRI were used with minor modifications. For the patients with suspected viral ALRI, a nasopharyngeal swab was obtained, and rapid tests for influenza and respiratory syncytial virus (RSV) were performed, followed by real-time PCR for the 16 respiratory viruses causing ALRI. Clinical information was extracted from the medical records. Results Among the 5463 patients admitted with a diagnosis of ALRI, 570 (10.4%) were randomly enrolled in the study. The median age of the patients was 8 months (interquartile range, 4–15 months). The most common symptoms were cough (93%) and difficulty of breathing (73%), while the most common signs were tachypnoea (78%) and chest indrawing (67%). Sixteen potentially causative viruses were detected in 502 (88%) patients, with RSV B (36%) and rhinovirus (28%) being the most commonly detected. Multiple viruses were detected simultaneously in 221 patients (37%). Severe ALRI was diagnosed in 107 patients (19%). The mortality rate was 5%; influenza virus A (29%) and RSV B (21%) were commonly detected in such cases. Conclusions Viral ALRI in children has significant morbidity and mortality rates in Myanmar. RSV and rhinovirus were the most commonly detected, while influenza virus and RSV were the most common causes of mortality.

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“…3 ISPA merupakan penyebab utama morbiditas dan mortalitas pada semua kelompok usia di negara berpendapatan menengah ke bawah. 4 ISPA bawah yang paling sering terjadi pada anak serta yang menjadi penyebab kematian terbanyak pada anak berusia <1 tahun adalah pneumonia dan bronkiolitis. 5 Bronkiolitis merupakan penyebab tersering perawatan rumah sakit pada masa bayi dan sering terjadi kesalahan diagnosis dengan asma bronkial.…”

Section: Pendahuluanunclassified

Bronkiolitis akut pada bayi: laporan kasus

Hsieh

Sindhu

Mapantow

2022

Intisari Sains Medis

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Introduction: Acute respiratory tract infection (ARI) is the major cause of mortality and morbidity in low – and middle–income countries. Bronchiolitis is the most common respiratory tract infection in <2 years old individuals but is often confused with bronchial asthma. This report aims to describe the difference between those two diseases. Case: Eight–month–old baby girl presented with shortness of breath, abnormal breathing sound, productive cough, fever, nasal discharge, and vomiting for 3 days. She’s got a history of abnormal breathing sound at 4 months old. Parents had no history of allergy or asthma. On examination, she was alert, weighed 6,8 kg, had an axillary temperature of 37°C, heart rate of 128/min, respiratory rate of 56/min with subcostal retraction, rhonchi, and wheezing on both chests. Laboratory findings showed hemoglobin of 11,2 g/dL, hematocrit of 32,3%, leukocyte count of 10.810/mm³, thrombocyte count of 361.000/mm³. Serum electrolytes and blood sugar levels were within normal limits. Chest radiograph showed patchy perihilar infiltrates on both lungs and hyperinflation. She was diagnosed with bronchiolitis and was treated with KAEN3B 700 cc/24 hours, nasal oxygen 2 L/min, 3 x 200 mg ampicillin, 2 x 15 mg gentamicin, 3 x 1 mg dexamethasone, ipratropium bromide and albuterol nebulization 3 times daily, 3 x 70 mg oral paracetamol. Her condition improved, and she was discharged after 7 days of hospitalization. Conclusion: There are fundamental differences in clinical profiles between bronchiolitis and bronchial asthma, which have to be carefully examined to prevent misdiagnosis. Latar Belakang: Infeksi saluran pernafasan akut (ISPA) merupakan masalah utama penyebab mortalitas dan morbiditas di negara berpenghasilan menengah ke bawah. Bronkiolitis merupakan salah satu infeksi saluran nafas tersering pada anak berusia di bawah 2 tahun yang sering dikira sebagai asma bronkial. Laporan ini bertujuan untuk memberi gambaran perbedaan antara kedua penyakit tersebut. Kasus: Bayi perempuan berusia 8 bulan datang dengan keluhan sesak, suara nafas abnormal, batuk berdahak, demam, pilek, dan muntah selama 3 hari. Pasien memiliki riwayat suara nafas abnormal pada usia 4 bulan. Baik pasien maupun orangtua tidak memiliki riwayat alergi maupun asma bronkial. Pada pemeriksaan fisik, pasien sadar, berat badan 6,8 kg, suhu aksila 37° C, nadi 128 kali/menit, laju pernafasan 56 kali/menit, dan didapatkan retraksi subkostal, ronkhi, serta wheezing pada kedua lapang paru. Hasil laboratorium menunjukkan kadar hemoglobin 11,2 g/dL, leukosit 10.810/mm3, trombosit 361.000/mm3, hematokrit 32,3% dengan kadar elektrolit normal. Pemeriksaan foto toraks menunjukkan gambaran hiperinflasi serta patchy infiltrates pada perihilar kanan dan kiri. Pasien didiagnosis menderita bronkiolitis dan mendapatkan terapi cairan dengan KAEN3B 700 cc/ 24 jam, injeksi ampisilin 3 x 200 mg, injeksi gentamicin 2 x 15 mg, injeksi dexamethasone 3 x 1 mg, nebulisasi ipratropium bromide dan albuterol 3 kali/ hari, serta parasetamol oral 3 x 70 mg. Pada hari ke 7, pasien dipulangkan dalam kondisi sehat. Simpulan: Terdapat perbedaan mendasar pada gejala klinis bronkiolitis dan asma bronkial yang jika tidak dicermati dengan hati – hati akan menyebabkan kesalahan diagnosis.

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Clinical and Epidemiological Determinants of Lower Respiratory Tract Infections in Hospitalized Pediatric Patients

Cited by 10 publications

References 36 publications

Clinical manifestations and outcome of viral acute lower respiratory infection in hospitalised children in Myanmar

Clinical manifestations and outcome of viral acute lower respiratory infection in hospitalised children in Myanmar

Title: Clinical Manifestations and Outcome of Viral Acute Lower Respiratory Infection in Hospitalised Children in Myanmar

Bronkiolitis akut pada bayi: laporan kasus

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